The latest iteration of the tool maps the geographic density of specific healthcare service providers and the number of Medicare beneficiaries using those services.
The Centers for Medicare & Medicaid Services has unveiled an expanded version of a data tool that features interactive maps for market saturation and utilization of several healthcare services at the national, state and county level.
The Market Saturation and Utilization Data Tool was developed for use by providers to help analyze their service locations and the service utilization rates of Medicare beneficiaries.
CMS uses the data tool's market saturation and healthcare service utilization information as one means of rooting out fraud and waste in the Medicare program. The tool was formerly called the Moratoria Provider Services and Utilization Data Tool.
Market saturation is defined as the density of providers offering a particular healthcare service in a geographic area relative to the number of Medicare beneficiaries who utilize the service in that area.
Improvements to the tool include an increase in the number of healthcare-service categories from eight to ten. CMS added clinical laboratories that bill independently of other facilities and physical and occupational therapy services.
The interactive-map function of the data tool offers two display options: nation-by-state and state-by-county.
In addition to two color-coding options, the interactive-map function features pull-down menus with three sets of data: 10 healthcare service categories, four yearlong reference time periods, and five Medicare data metrics.
Healthcare service categories:
- Emergency ambulance service
- Nonemergency ambulance service
- Emergency and nonemergency ambulance service
- Clinical laboratory that bills independently from other facilities
- Home health
- Hospice
- Medicare Part A independent diagnostic testing facility
- Medicare Part B independent diagnostic testing facility
- Physical and occupational therapy
- Skilled nursing facility
Yearlong reference time periods:
- October 2014 through September 2015
- January 2015 through December 2015
- April 2015 through March 2016
- July 2015 through June 2016
Medicare data metrics:
- Number of Medicare fee-for-service beneficiaries
- Number of service providers
- Number of users per service provider
- Percentage of users out of fee-for-service beneficiaries
- Average number of service providers per county
The latest version of the tool is its fourth update.
Christopher Cheney is the CMO editor at HealthLeaders.