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MIPS Cost Analytics

MIPS Cost Analytics compiles all claims for your Medicare patients, providing a comprehensive overview of your patients’ healthcare journey and your cost score.

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Find clarity in complex cost measures

As CMS returns to providing Cost category scores and many MIPS-eligible providers receive subpar scores, the need to understand cost measures has grown. Our industry-first MIPS Cost Analytics software gives you the insights you need to succeed in the Cost category. 

MIPS Cost Analytics provides a clear picture of the cost measures included in your Cost category score, based on your exact billing. It also helps you determine actionable insights to improve your scores. These insights are valuable not only for your MIPS incentives but also are becoming more applicable to other payer models.

Don’t settle for mediocre Cost scores.  Empower your doctors with full insight into the care that their MIPS Cost scores include. 

Use MIPS Cost Analytics to receive faster access to more robust data than Medicare can provide today. Find insights to raise your score in coming years as the incentives and penalties grow.

See how MIPS Cost Analytics benefits you

Whether you’re a large health system, a provider network, or an EHR, MIPS Cost Analytics helps you understand the cost of patient care. We have the data organized in a format to provide the first steps to improvement.

  • Review a full picture of care for all attributed patients and identify revenue opportunities.
  • Identify your top providers and those who are lagging behind.
  • Increase awareness for the cost of care services for qualified inpatient hospital stays.
  • Determine the entire cost of care (not just your practice) clinically related to initial patient treatment and provided during an episode’s time frame.

MIPS Cost Analytics features

  • Receive quarterly access to updated Medicare Parts A, B, and D claims data.
  • See total claims for each of your Medicare patients, even outside your network.
  • Estimate and improve your MIPS Cost category score.
  • Compare patient claims and costs by clinician to identify care and cost variations.
  • Obtain comparative data for all providers inside and outside your organization.
  • Drill into Total Per Capita Cost (TPCC), Medicare Spending Per Beneficiary Clinician (MSBP-C), and episode-based cost measures for all your patients.

Other features include HCC scoring, identification of highest-cost patients, and the ability to drill down into patient and provider data. You can also identify opportunities to reduce out-of-network referrals and target potential physician and other partnerships to drive new revenue and optimize care.


How often will I receive new Medicare claims data?

We provide your claims data from CMS quarterly.

How many years of Medicare claims data can I view?

You can view data for the current reporting year and the 2 prior years.

What information can I view for patient treatment outside of my practice or network?

MIPS Cost Analytics provides access to all Medicare claims for your patients, including episodes of care, Total Per Capita Cost (TPCC), and Medicare Spending Per Beneficiary Clinician (MSPB-C). This allows you to estimate your MIPS Cost score.