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Documentation/Drug Intelligence/Insights

Insights

35+ prepared ranking questions over Medicare provider, facility and ACO data, with scope and cohort controls.

Open Insights -- in the sidebar under Workspace.

Insights is a question picker. The left pane lists prepared questions; the right pane runs the ranking and shows the answer with a short narrative explaining why it matters.

Every question is a real query against the Medicare public files, not a saved screenshot. Changing scope re-runs it.

Question categories

CategoryExamples
Ask by DrugWho prescribes a specific drug the most; who writes the most claims for it; who puts the most patients on it; who spends most per patient on it; who spends most on a brand that has a cheap generic
Spend and Money FlowWhere is Medicare drug money going; who spends most on brand-name drugs; who submits the largest charges; who collects the most from Medicare
Volume and ThroughputWho writes the most generic prescriptions; who bills for the most services; who serves the most beneficiaries; who performs the widest variety of procedures; who writes the most prescriptions overall
Risk and Prescribing PatternsWho writes the most opioid prescriptions; which prescribers are most opioid-dependent; who writes the most antibiotics; who treats the highest-risk panels
Behavior and EfficiencyWhich high-volume prescribers lean hardest on brand-name drugs; who bills farthest above the allowed amount; which prescribers spend most per patient
Scored Target ListsBest diabetes drug launch targets; highest-priority oncology accounts; best cardiovascular drug targets
Chronic-Condition SpecialistsWho treats the most cancer, diabetes, cardiovascular, dementia, depression or chronic kidney disease patients
Capacity and FootprintWhich hospitals have the most inpatient capacity; which laboratories run the most tests
Value-Based CareACO quality scores, savings, savings rate, beneficiaries covered, counties served, participating providers

Question kinds

Behind the categories, questions run in four different ways:

  • Ranking -- straight sort on one field. "Who writes the most prescriptions."
  • Ratio -- a computed share, markup, per-unit or prevalence figure over a qualified pool, with a minimum denominator so tiny panels do not top the list. "Brand reliance", "charge aggression".
  • Composite -- a weighted multi-factor score. The scored target lists combine, for example, diabetes prevalence (weight 3), brand spend (weight 2) and patient complexity (weight 1).
  • Savings -- generic-substitution opportunity sizing.
  • Composite questions show their factor weights, so you can see exactly what produced the ranking.

    Scope controls

    Where a question supports them, the right pane offers:

    • State -- restrict to one state.
    • Specialty -- restrict to one primary specialty. The specialty list is fetched live from the dataset the question runs against.
    • Drug -- for Ask-by-Drug questions, pick a brand or generic name. A brand/generic toggle switches which vocabulary you are searching.
    • Cohort -- restrict to providers whose panel exceeds a chronic-condition prevalence threshold.

    Cohort filtering

    Cohorts let you ask "among providers whose panel is at least 30 percent diabetic, who spends the most on brand drugs?"

    Available conditions: diabetes, cancer, ischemic heart disease, heart failure, atrial fibrillation, chronic kidney disease, COPD, asthma, Alzheimer and dementia, depression, anxiety, schizophrenia, osteoporosis, arthritis, stroke, hypertension, hyperlipidemia, Parkinson, tobacco use, alcohol and drug use.

    Thresholds: 10, 20, 30, 40 or 50 percent. Default is 20.

    Prevalence-based questions require a minimum panel size so that a provider with a handful of beneficiaries cannot show 100 percent prevalence.

    Results

    Each result row links through to the underlying record page (provider, facility or ACO) and to the source table. The default result limit is 20 rows.

    Use Save as list to push the ranked result straight into a lead list.

    Limitations

    • Medicare public files are aggregated and lagged. They describe Medicare fee-for-service activity, not total practice activity, and not commercial payers.
    • providers and provsummary use different specialty vocabularies (for example CHIROPRACTOR versus CHIROPRACTIC). A specialty chosen in one context may not exist in the other. Insights always fetches its specialty list from the dataset it will actually query, but be careful when carrying a specialty value between pages by hand.