Methodology
How provider peer groups, percentiles, KOL tiers and similar providers are computed, and how Qope matches records across datasets.
This page explains the numbers Qope derives rather than copies: peer percentiles, KOL tiers and similar providers on provider pages, and the rules used to connect one dataset to another.
Every provider figure here comes from the CMS Medicare provider files for data year 2024 (see Sources and Freshness). Those files cover Medicare fee-for-service only. Commercial insurance, Medicaid, Medicare Advantage and cash business are not in them, so a provider with a small Medicare panel looks small here whatever the size of the practice.
Peer groups
A provider is compared with a peer group built from the Medicare provider summary file:
- Same specialty, same state -- every provider in the file with the same primary specialty, matched exactly, in the same state. The specialty is the one CMS reports in the Medicare file, which can differ from the NPPES taxonomy shown in the provider header.
- All providers in the state -- used instead when fewer than 6 providers in the state share the specialty, or when the specialty name contains a comma (such names cannot be filtered, see Data Caveats). If the whole state has 10,000 providers or fewer and at least 5 others share the exact specialty, the group narrows back to that specialty.
The provider itself is always left out of its own comparison.
Full group or sample
| Group size | What the provider is compared with | How the page labels it |
|---|---|---|
| 10,000 providers or fewer | Every provider in the group | vs all 1,918 cardiology providers in CA |
| More than 10,000 providers | A sample of about 1,000: 10 blocks of 100 providers, evenly spaced across the whole group ordered by NPI | vs a 978-provider sample of 16,578 internal medicine providers in CA |
For scale, California group sizes in 2024 data: cardiology 1,918, hematology-oncology 1,040, family practice 13,887, internal medicine 16,578, nurse practitioner 18,403, and 177,585 providers in the state overall. So a cardiologist or oncologist is ranked against every peer, while an internist or nurse practitioner in a large state is ranked against a sample.
The sampling method was checked on 2024 groups small enough to compare in full (Florida internal medicine, 9,603 providers, and California cardiology, 1,918). On the three KOL measures, 95% of ranks taken from the 10-block sample were within 2 percentile points of the full-group rank, and none was more than 3 points off. Near a tier boundary that is enough to move a provider by one KOL tier, which happened for 1.5% to 3.2% of providers in those checks. A sampled page says so in its label.
A peer group is loaded once and reused for up to a day. If it cannot be loaded, percentiles, the KOL tier and similar providers show as unavailable. They are never shown as zero, and a partial group is never presented as a complete one.