CareJourney: Provider Data Solutions

CareJourney’s Provider Data Solutions data asset is the first comprehensive value based care resource to help you improve provider performance and referrals, grow your network, and build data-driven care teams.

Healthcare stakeholders have generally operated with insufficient data. Critical decisions regarding patient care, referrals, and provider performance have been made using incomplete, scattered, un-actionable datasets, resulting in patients and providers paying the price, both financially and with their most precious currency: patient health.

With over 2 million NPIs profiled, CareJourney’s data asset enables increased focus on making critical data-driven decisions around finding and recruiting the best providers who deliver high-quality, low-cost care.

Data sources:
- CMS Medicare fee-for-service claims details
- CMS Physician Compare
- NPPES data
- QPP eligibility data

Each view (by year) is organized by:
- Provider
- Provider x Facility
- Provider x APM
- Provider x Procedure
- Provider x Episode

Sample fields include:
Demographic Metrics
- Provider ID (NPI)
- Geographic Details
- Year
- Practice Group Affiliation
- Hospital Affiliation
- Taxonomy (NPPES and CareJourney)
- Number of Patients

Premium Metrics
- Medical Codes (procedure and diagnosis)
- CareJourney Cost Index
- CareJourney Outcomes Index
- Allowed Amount
- Number of Claims
- Episode Type
- Count of Episodes
- Observed Allowed Amount
- Expected Amount
- Average Risk Score
- Allowed Amount by Site of Service
- Episode Cost & Utilization
- Rate of Performance
- Probability of Performing Better
- Benchmarks
- Referral data including specialty, number of patients, allowed amounts etc.