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Version: Canary - 2.3 🚧

v2_2_2 → v2_3_0

Generated: 2025-11-27 17:24:31.
Filter: canonical_rate_score > 1.


1. Summary Statistics

Overview

  • Total ROIDs: 401,858,174 → 378,780,950 (-23,077,224, -5.7%)

By Provider Type and Bill Type

provider_typebill_typenew_distinct_roidsold_distinct_roidsnew_distinct_networksold_distinct_networksnew_distinct_providersold_distinct_providersnew_distinct_billing_codesold_distinct_billing_codes
ASCOutpatient15,194,45125,049,8841431395,5905,5833,3693,371
Physician GroupProfessional150,471,614152,596,54916716717,33516,5003,7812,838
HospitalInpatient41,786,02442,273,3471671685,5945,5711,7171,716
LaboratoryProfessional3,535,4612,158,493146149696718917917
Imaging CenterProfessional2,980,1873,028,8491501512,9762,987172172
HospitalOutpatient164,813,213176,751,0521671685,6475,6207,0647,064
Click to see SQL
WITH
new AS (
SELECT
provider_type,
bill_type,
COUNT(DISTINCT roid) AS distinct_roids,
COUNT(DISTINCT payer_id) AS distinct_payers,
COUNT(DISTINCT network_id) AS distinct_networks,
COUNT(DISTINCT provider_id) AS distinct_providers,
COUNT(DISTINCT billing_code) AS distinct_billing_codes
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY 1,2
),
old AS (
SELECT
CASE
WHEN provider_type LIKE '%Hospital%' THEN 'Hospital'
ELSE provider_type
END AS provider_type,
bill_type,
COUNT(DISTINCT roid) AS distinct_roids,
COUNT(DISTINCT payer_id) AS distinct_payers,
COUNT(DISTINCT network_id) AS distinct_networks,
COUNT(DISTINCT provider_id) AS distinct_providers,
COUNT(DISTINCT billing_code) AS distinct_billing_codes
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY 1, 2
)
SELECT
provider_type,
bill_type,
new.distinct_roids AS new_distinct_roids,
old.distinct_roids AS old_distinct_roids,
new.distinct_networks AS new_distinct_networks,
old.distinct_networks AS old_distinct_networks,
new.distinct_providers AS new_distinct_providers,
old.distinct_providers AS old_distinct_providers,
new.distinct_billing_codes AS new_distinct_billing_codes,
old.distinct_billing_codes AS old_distinct_billing_codes
FROM new
JOIN old USING (provider_type, bill_type)

2. Rate Object Space Dropoffs

Provider Dropoffs

Count: 1231 dropped

Click to see SQL
WITH
new AS (
SELECT DISTINCT provider_id, 'new' as source
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
),
old AS (
SELECT DISTINCT provider_id, 'old' as source
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
)
SELECT
DISTINCT
provider_id
FROM new
FULL OUTER JOIN old USING (provider_id)
WHERE new.source IS NULL AND old.source IS NOT NULL

Payer Dropoffs

Count: 1 dropped

Click to see SQL
WITH
new AS (
SELECT DISTINCT payer_id, 'new' as source
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
),
old AS (
SELECT DISTINCT payer_id, 'old' as source
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
)
SELECT
DISTINCT
payer_id
FROM new
FULL OUTER JOIN old USING (payer_id)
WHERE new.source IS NULL AND old.source IS NOT NULL

Network Dropoffs

Count: 1 dropped

Click to see SQL
WITH
new AS (
SELECT DISTINCT network_id, 'new' as source
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
),
old AS (
SELECT DISTINCT network_id, 'old' as source
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
)
SELECT
DISTINCT
network_id
FROM new
FULL OUTER JOIN old USING (network_id)
WHERE new.source IS NULL AND old.source IS NOT NULL

Provider-Network Combination Dropoffs

Count: 8196 dropped

Click to see SQL
WITH
new AS (
SELECT DISTINCT provider_id, network_id, 'new' as source
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
),
old AS (
SELECT DISTINCT provider_id, network_id, 'old' as source
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
)
SELECT
DISTINCT
provider_id,
network_id
FROM new
FULL OUTER JOIN old USING (provider_id, network_id)
WHERE new.source IS NULL AND old.source IS NOT NULL

Bill Type-Billing Code Combination Dropoffs

Count: 12 dropped

Click to see SQL
WITH
new AS (
SELECT DISTINCT bill_type, billing_code, 'new' as source
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
),
old AS (
SELECT DISTINCT bill_type, billing_code, 'old' as source
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
)
SELECT
DISTINCT
bill_type,
billing_code
FROM new
FULL OUTER JOIN old USING (bill_type, billing_code)
WHERE new.source IS NULL AND old.source IS NOT NULL

3. Large Rate Swings (>10% change)

Bill Type + Provider Level

Count: 19465 entities with significant rate changes

bill_typeprovider_idnew_avg_pct_of_medicare_rateold_avg_pct_of_medicare_ratenew_avg_canonical_rateold_avg_canonical_ratemedicare_rate_pct_changecanonical_rate_pct_changenew_roid_countold_roid_count
Outpatient97322.860.657,973.482,834.54342.7%181.3%10,98510,281
Inpatient60766.621.75111,634.9232,695.22278.3%241.4%1011,497
Outpatient235495.31.538,180.791,530.04245.9%434.7%876644
Outpatient99603.020.97,057.041,252.20234.3%463.6%8,13011,494
Inpatient55813.611.153,993.8719,401.32228.7%178.3%1,8053,753
Inpatient15925.491.7558,349.6729,629.84213.0%96.9%4822,559
Outpatient2642430.97569.37706.45209.2%-19.4%1,56211,456
Professional-76980441486952289473.321.092,013.67193.25204.4%942.0%3,6342,069
Outpatient308592.010.661,912.05877.40203.9%117.9%5134,051
Inpatient99333.591.1865,312.1218,760.62203.5%248.1%13,0085,926
Outpatient243552.170.721,067.68979.41202.9%9.0%5623,128
Inpatient60697.192.42115,494.7745,727.48197.6%152.6%3217,659
Outpatient316145.691.922,348.41556.02195.6%322.4%9026,140
Outpatient671310.913.984,991.554,402.45174.3%13.4%4,80212,018
Outpatient41627.642.865,977.862,842.82166.8%110.3%3,9818,774
Outpatient191010.463.9229,892.2811,499.67166.7%159.9%22,05428,997
Outpatient258722.330.871,740.06755.14166.2%130.4%5176,263
Outpatient228892.060.781,008.00629.76164.6%60.1%5436,764
Professional57306807574096793852.540.981,801.78237.80159.3%657.7%4,1722,644
Outpatient283701.680.652,768.341,226.79159.1%125.7%9203,268
Inpatient67136.182.4175,760.6941,747.74156.0%81.5%2174,374
Outpatient265272.240.89784.50812.71152.8%-3.5%6544,037
Outpatient227142.10.84468.16502.72151.3%-6.9%3,48913,903
Professional-44846416177257740882.420.962,005.04173.32151.0%1056.8%3,6062,166
Outpatient57641.650.67734.59693.37147.9%5.9%2,7739,601
Professional-19380683386010737672.350.962,109.42173.36144.8%1116.8%3,4061,962
Outpatient253042.541.04865.60855.30144.7%1.2%5245,437
Outpatient323982.40.991,515.51998.28143.5%51.8%7062,882
Outpatient218571.950.81446.34509.94140.9%-12.5%4,39216,321
Outpatient260382.30.961,955.661,093.04140.3%78.9%5774,849
Outpatient89811.120.47297.02472.62139.9%-37.2%2,2509,758
Outpatient288362.150.915,781.501,750.43135.7%230.3%9402,488
Outpatient94880.920.39527.63453.36134.4%16.4%2,3668,668
Inpatient65586.142.62103,457.0044,508.25134.2%132.4%6152,824
Outpatient286311.830.81,447.871,047.38128.4%38.2%5072,462
Outpatient102661.120.49300.72415.61126.7%-27.6%2,2519,212
Outpatient106611.120.49299.36413.14126.6%-27.5%2,2529,266
Professional-44944411840129792312.671.181,972.49222.12126.6%788.0%1,240697
Outpatient55715.022.227,511.403,732.50125.9%101.2%13,59025,530
Outpatient203796.522.893,840.661,564.44125.5%145.5%9093,843
Outpatient89212.541.131,053.651,042.39125.5%1.1%2,9087,696
Professional18737991072036586952.180.971,758.85247.87125.5%609.6%4,2812,726
Professional-39722531856128171433.611.61969.68196.86124.5%392.6%1,02813,119
Professional38956275737002070232.271.011,688.11233.76124.4%622.2%1,486932
Outpatient83651.120.5301.38436.10123.1%-30.9%2,2458,625
Outpatient259151.890.85423.28506.10122.1%-16.4%1,8605,468
Professional-89523905841309727342.160.971,731.28245.18122.1%606.1%4,3532,778
Outpatient283991.630.742,531.851,141.38120.4%121.8%6142,790
Outpatient221661.490.681,729.12724.33119.8%138.7%5045,282
Outpatient89221.960.895,799.711,899.05119.7%205.4%9,34015,868

Showing 50 of 19465 total rows

Click to see SQL
WITH
new AS (
SELECT
bill_type,
provider_id,
AVG(canonical_rate_percent_of_medicare) AS avg_pct_of_medicare_rate,
AVG(canonical_rate) AS avg_canonical_rate,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY bill_type, provider_id
),
old AS (
SELECT
bill_type,
provider_id,
AVG(canonical_rate_percent_of_medicare) AS avg_pct_of_medicare_rate,
AVG(canonical_rate) AS avg_canonical_rate,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY bill_type, provider_id
)
SELECT
bill_type,
provider_id,
new.avg_pct_of_medicare_rate AS new_avg_pct_of_medicare_rate,
old.avg_pct_of_medicare_rate AS old_avg_pct_of_medicare_rate,
new.avg_canonical_rate AS new_avg_canonical_rate,
old.avg_canonical_rate AS old_avg_canonical_rate,
(new.avg_pct_of_medicare_rate - old.avg_pct_of_medicare_rate) / NULLIF(old.avg_pct_of_medicare_rate, 0) AS medicare_rate_pct_change,
(new.avg_canonical_rate - old.avg_canonical_rate) / NULLIF(old.avg_canonical_rate, 0) AS canonical_rate_pct_change,
new.roid_count AS new_roid_count,
old.roid_count AS old_roid_count
FROM new
JOIN old USING (bill_type, provider_id)
WHERE (
ABS((new.avg_pct_of_medicare_rate - old.avg_pct_of_medicare_rate) / NULLIF(old.avg_pct_of_medicare_rate, 0)) > 0.1
OR ABS((new.avg_canonical_rate - old.avg_canonical_rate) / NULLIF(old.avg_canonical_rate, 0)) > 0.1
) AND (
CASE
WHEN bill_type = 'Inpatient'
THEN new.roid_count > 10 AND old.roid_count > 10
WHEN bill_type = 'Outpatient'
THEN new.roid_count > 500 AND old.roid_count > 500
WHEN bill_type = 'Professional'
THEN new.roid_count > 500 AND old.roid_count > 500
END
)
ORDER BY ABS(medicare_rate_pct_change) DESC

Network + Provider Level

Count: 81056 entities with significant rate changes

network_idprovider_idnew_avg_pct_of_medicare_rateold_avg_pct_of_medicare_ratenew_avg_canonical_rateold_avg_canonical_ratemedicare_rate_pct_changecanonical_rate_pct_changenew_roid_countold_roid_count
4,988,414,509,075,400,58155715.931.39,143.478,035.47356.2%13.8%1,8547,719
-2,162,498,661,799,343,23789816952665972577812.920.68105.0359.98331.7%75.1%636631
8,361,580,493,441,765,26519107.231.7921,087.942,015.35303.5%946.4%4,7906,524
4,988,414,509,075,400,581318365.271.338,171.801,851.16295.1%341.4%875505
5,075,764,097,723,629,05954737455829027265613.50.911,645.28255.32285.1%544.4%1,5911,119
-558,178,834,365,778,97854737455829027265613.50.911,645.28255.32285.1%544.4%1,5911,119
-2,162,498,661,799,343,23797322.420.659,986.692,837.10274.2%252.0%5,9835,143
4,988,414,509,075,400,581286865.341.458,163.631,492.65268.3%446.9%879850
-2,162,498,661,799,343,23730472.720.7417,318.79882.12267.0%1863.3%5,431787
-2,162,498,661,799,343,237245992.530.711,297.40534.61253.9%142.7%2,222838
-2,162,498,661,799,343,237671312.563.569,417.4414,850.17252.9%-36.6%1,2584,942
-3,776,001,016,975,145,508671311.213.210,336.7216,218.06250.2%-36.3%1,0874,940
5,075,764,097,723,629,059-861262953598516073130.862,160.72158.09249.6%1266.8%1,110649
-558,178,834,365,778,978-861262953598516073130.862,160.72158.09249.6%1266.8%1,110649
4,988,414,509,075,400,581235495.31.538,180.791,530.04245.9%434.7%876644
-2,162,498,661,799,343,2377132.530.732,615.38521.46245.2%401.6%3,198502
8,361,580,493,441,765,26540234.841.4420,665.4415,038.59236.4%37.4%7,6853,173
-3,063,756,195,086,079,59898425.411.6122,178.2128,064.91236.1%-21.0%6,4592,299
-2,162,498,661,799,343,23736484.951.4912,174.683,010.96232.4%304.3%5,1885,949
-7,940,170,945,989,807,859671310.613.198,014.6414,337.07232.4%-44.1%1,7345,544
5,075,764,097,723,629,059211872926223523107030.92,214.92163.29232.2%1256.4%1,081619
-558,178,834,365,778,978211872926223523107030.92,214.92163.29232.2%1256.4%1,081619
5,075,764,097,723,629,05956515482399535305173.080.931,908.13160.18231.8%1091.2%1,274768
-558,178,834,365,778,97856515482399535305173.080.931,908.13160.18231.8%1091.2%1,274768
-6,972,129,921,516,377,12663544.11.2512,740.21847.69229.4%1402.9%5,6294,453
-2,162,498,661,799,343,23743431.840.561,927.31171.60228.6%1023.2%3,791574
-558,178,834,365,778,97869025906223121448852.940.911,597.68264.47224.0%504.1%1,6371,124
5,075,764,097,723,629,05969025906223121448852.940.911,597.68264.47224.0%504.1%1,6371,124
-2,162,498,661,799,343,237316432.340.732,075.11534.41221.9%288.3%2,541826
-4,541,460,228,936,150,43754976489294733937773.651.152,065.01210.61218.7%880.5%1,188667
-2,162,498,661,799,343,23713173.41.0714,880.796,043.47217.1%146.2%8,2986,661
-558,178,834,365,778,978-40425152201492440833.030.962,108.36174.90214.9%1105.4%1,144650
5,075,764,097,723,629,059-40425152201492440833.030.962,108.36174.90214.9%1105.4%1,144650
5,075,764,097,723,629,059-76980441486952289473.31.062,010.30187.16211.7%974.1%1,211689
-558,178,834,365,778,978-76980441486952289473.31.062,010.30187.16211.7%974.1%1,211689
4,281,965,180,796,802,41354301.940.631,834.911,327.50209.4%38.2%8163,895
8,361,580,493,441,765,26554301.940.631,834.911,327.50209.4%38.2%8163,895
4,988,414,509,075,400,581297055.441.778,200.581,382.42207.5%493.2%871560
-2,162,498,661,799,343,23798583.141.0422,967.05745.21200.6%2982.0%4,3791,712
3,973,810,847,438,814,798191015.545.1749,267.4426,697.24200.4%84.5%3,5415,923
-558,178,834,365,778,97881889988561880512012.720.911,786.33230.38200.1%675.4%1,405912
5,075,764,097,723,629,05981889988561880512012.720.911,786.33230.38200.1%675.4%1,405912
-558,178,834,365,778,97854976489294733937773.151.062,045.99192.10198.2%965.1%1,187665
5,075,764,097,723,629,05954976489294733937773.151.062,045.99192.10198.2%965.1%1,187665
2,039,367,776,086,447,45498583.151.0621,056.67758.33197.3%2676.7%4,8451,716
-2,162,498,661,799,343,23711843.991.3514,630.123,614.81196.1%304.7%6,9194,736
-7,995,682,717,897,123,039231352.580.871,962.90741.52195.6%164.7%775849
4,281,965,180,796,802,41340234.041.3717,651.9513,736.66194.6%28.5%7,6853,173
-4,541,460,228,936,150,437-86126295359851607313.41.162,000.78212.77192.3%840.4%1,228707
-2,162,498,661,799,343,237191014.354.9245,972.9125,573.92191.3%79.8%3,7725,797

Showing 50 of 81056 total rows

Click to see SQL
WITH
new AS (
SELECT
network_id,
provider_id,
AVG(canonical_rate_percent_of_medicare) AS avg_pct_of_medicare_rate,
AVG(canonical_rate) AS avg_canonical_rate,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY network_id, provider_id
),
old AS (
SELECT
network_id,
provider_id,
AVG(canonical_rate_percent_of_medicare) AS avg_pct_of_medicare_rate,
AVG(canonical_rate) AS avg_canonical_rate,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY network_id, provider_id
)
SELECT
network_id,
provider_id,
new.avg_pct_of_medicare_rate AS new_avg_pct_of_medicare_rate,
old.avg_pct_of_medicare_rate AS old_avg_pct_of_medicare_rate,
new.avg_canonical_rate AS new_avg_canonical_rate,
old.avg_canonical_rate AS old_avg_canonical_rate,
(new.avg_pct_of_medicare_rate - old.avg_pct_of_medicare_rate) / NULLIF(old.avg_pct_of_medicare_rate, 0) AS medicare_rate_pct_change,
(new.avg_canonical_rate - old.avg_canonical_rate) / NULLIF(old.avg_canonical_rate, 0) AS canonical_rate_pct_change,
new.roid_count AS new_roid_count,
old.roid_count AS old_roid_count
FROM new
JOIN old USING (network_id, provider_id)
WHERE (
ABS((new.avg_pct_of_medicare_rate - old.avg_pct_of_medicare_rate) / NULLIF(old.avg_pct_of_medicare_rate, 0)) > 0.1
OR ABS((new.avg_canonical_rate - old.avg_canonical_rate) / NULLIF(old.avg_canonical_rate, 0)) > 0.1
) AND (
new.roid_count > 500 AND old.roid_count > 500
)
ORDER BY ABS(medicare_rate_pct_change) DESC

Network + Provider + Bill Type Level

Count: 87286 entities with significant rate changes

network_idprovider_idbill_typenew_avg_pct_of_medicare_rateold_avg_pct_of_medicare_ratenew_avg_canonical_rateold_avg_canonical_ratemedicare_rate_pct_changecanonical_rate_pct_changenew_roid_countold_roid_count
4,988,414,509,075,400,5815571Outpatient5.931.219,143.471,918.72390.9%376.5%1,8546,043
-2,162,498,661,799,343,2378981695266597257781Professional2.920.68105.0359.98331.7%75.1%636631
8,361,580,493,441,765,2651910Outpatient7.241.7820,787.221,771.01305.9%1073.7%4,7646,492
-2,162,498,661,799,343,2371317Outpatient3.930.9713,151.22674.64305.5%1849.4%6,5824,945
-3,776,001,016,975,145,5086076Inpatient7.111.76121,350.4833,163.45305.0%265.9%911,457
8,361,580,493,441,765,2654023Outpatient5.831.4718,931.901,217.32295.5%1455.2%5,9691,457
4,988,414,509,075,400,58131836Outpatient5.271.338,171.801,851.16295.1%341.4%875505
5,075,764,097,723,629,0595473745582902726561Professional3.50.911,645.28255.32285.1%544.4%1,5911,119
-558,178,834,365,778,9785473745582902726561Professional3.50.911,645.28255.32285.1%544.4%1,5911,119
-2,162,498,661,799,343,2373047Outpatient2.810.746,335.15882.12279.0%618.2%3,870787
-6,293,294,949,651,930,9731964Outpatient5.281.4118,050.2917,269.36273.4%4.5%4,3401,550
-2,162,498,661,799,343,2379732Outpatient2.410.659,038.462,837.10272.0%218.6%5,8815,143
4,988,414,509,075,400,58128686Outpatient5.341.458,163.631,492.65268.3%446.9%879850
5,373,876,635,451,223,8429933Inpatient4.51.2374,006.7525,664.83265.0%188.4%780152
-6,972,129,921,516,377,1269933Inpatient4.51.2374,006.7525,664.83265.0%188.4%780152
-3,063,756,195,086,079,5989842Outpatient6.821.916,468.32605.77259.6%2618.6%4,742583
4,988,414,509,075,400,5815581Inpatient3.741.0456,340.9020,052.27258.1%181.0%1,7161,623
-2,162,498,661,799,343,23724599Outpatient2.530.711,297.40534.61253.9%142.7%2,222838
-558,178,834,365,778,978-8612629535985160731Professional30.862,160.72158.09249.6%1266.8%1,110649
5,075,764,097,723,629,059-8612629535985160731Professional30.862,160.72158.09249.6%1266.8%1,110649
4,988,414,509,075,400,58123549Outpatient5.31.538,180.791,530.04245.9%434.7%876644
-2,162,498,661,799,343,237713Outpatient2.530.732,615.38521.46245.2%401.6%3,198502
-2,162,498,661,799,343,2373546Inpatient3.731.145,157.748,634.57238.4%423.0%51139
-2,162,498,661,799,343,2373648Outpatient5.011.4912,145.472,999.48236.0%304.9%5,1155,939
5,075,764,097,723,629,0592118729262235231070Professional30.92,214.92163.29232.2%1256.4%1,081619
-558,178,834,365,778,9782118729262235231070Professional30.92,214.92163.29232.2%1256.4%1,081619
5,075,764,097,723,629,0595651548239953530517Professional3.080.931,908.13160.18231.8%1091.2%1,274768
-558,178,834,365,778,9785651548239953530517Professional3.080.931,908.13160.18231.8%1091.2%1,274768
-6,972,129,921,516,377,1266354Outpatient4.111.2512,743.48841.59229.8%1414.2%5,6204,450
-6,588,387,606,928,155,169926Outpatient5.761.755,672.71563.16229.6%907.3%881613
-2,162,498,661,799,343,2374343Outpatient1.840.561,912.70163.30229.3%1071.3%3,784573
4,281,965,180,796,802,4134023Outpatient4.831.4715,728.681,217.32228.0%1192.1%5,9691,457
-3,776,001,016,975,145,5086713Outpatient11.543.526,661.055,043.44227.4%32.1%1,0253,465
8,361,580,493,441,765,2659933Inpatient3.731.1564,041.4517,277.53224.2%270.7%891112
4,281,965,180,796,802,4139933Inpatient3.731.1564,041.4517,277.53224.2%270.7%891112
-558,178,834,365,778,9786902590622312144885Professional2.940.911,597.68264.47224.0%504.1%1,6371,124
5,075,764,097,723,629,0596902590622312144885Professional2.940.911,597.68264.47224.0%504.1%1,6371,124
-2,162,498,661,799,343,2376713Outpatient12.934.015,752.154,768.46222.2%20.6%1,1913,564
-2,162,498,661,799,343,23731643Outpatient2.340.732,075.11534.41221.9%288.3%2,541826
-3,776,001,016,975,145,5081592Inpatient5.941.8663,024.5231,787.21218.9%98.3%2381,306
-4,541,460,228,936,150,4375497648929473393777Professional3.651.152,065.01210.61218.7%880.5%1,188667
-558,178,834,365,778,978-4042515220149244083Professional3.030.962,108.36174.90214.9%1105.4%1,144650
5,075,764,097,723,629,059-4042515220149244083Professional3.030.962,108.36174.90214.9%1105.4%1,144650
4,281,965,180,796,802,4135430Outpatient1.950.621,220.801,215.86214.0%0.4%7893,870
8,361,580,493,441,765,2655430Outpatient1.950.621,220.801,215.86214.0%0.4%7893,870
5,075,764,097,723,629,059-7698044148695228947Professional3.31.062,010.30187.16211.7%974.1%1,211689
-558,178,834,365,778,978-7698044148695228947Professional3.31.062,010.30187.16211.7%974.1%1,211689
-7,940,170,945,989,807,8596713Outpatient10.793.475,218.294,138.84211.2%26.1%1,6664,069
-8,389,359,264,395,369,9791106Inpatient5.231.795,741.7030,213.26208.6%216.9%1,6051,708
-2,162,498,661,799,343,2379858Outpatient3.211.046,249.50745.21207.7%738.6%2,7511,712

Showing 50 of 87286 total rows

Click to see SQL
WITH
new AS (
SELECT
network_id,
provider_id,
bill_type,
AVG(canonical_rate_percent_of_medicare) AS avg_pct_of_medicare_rate,
AVG(canonical_rate) AS avg_canonical_rate,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY network_id, provider_id, bill_type
),
old AS (
SELECT
network_id,
provider_id,
bill_type,
AVG(canonical_rate_percent_of_medicare) AS avg_pct_of_medicare_rate,
AVG(canonical_rate) AS avg_canonical_rate,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY network_id, provider_id, bill_type
)
SELECT
network_id,
provider_id,
bill_type,
new.avg_pct_of_medicare_rate AS new_avg_pct_of_medicare_rate,
old.avg_pct_of_medicare_rate AS old_avg_pct_of_medicare_rate,
new.avg_canonical_rate AS new_avg_canonical_rate,
old.avg_canonical_rate AS old_avg_canonical_rate,
(new.avg_pct_of_medicare_rate - old.avg_pct_of_medicare_rate) / NULLIF(old.avg_pct_of_medicare_rate, 0) AS medicare_rate_pct_change,
(new.avg_canonical_rate - old.avg_canonical_rate) / NULLIF(old.avg_canonical_rate, 0) AS canonical_rate_pct_change,
new.roid_count AS new_roid_count,
old.roid_count AS old_roid_count
FROM new
JOIN old USING (network_id, provider_id, bill_type)
WHERE (
ABS((new.avg_pct_of_medicare_rate - old.avg_pct_of_medicare_rate) / NULLIF(old.avg_pct_of_medicare_rate, 0)) > 0.1
OR ABS((new.avg_canonical_rate - old.avg_canonical_rate) / NULLIF(old.avg_canonical_rate, 0)) > 0.1
) AND (
CASE
WHEN bill_type = 'Inpatient'
THEN new.roid_count > 10 AND old.roid_count > 10
WHEN bill_type = 'Outpatient'
THEN new.roid_count > 500 AND old.roid_count > 500
WHEN bill_type = 'Professional'
THEN new.roid_count > 500 AND old.roid_count > 500
END
)
ORDER BY ABS(medicare_rate_pct_change) DESC

Network Level

Count: 59 entities with significant rate changes

network_idnew_avg_pct_of_medicare_rateold_avg_pct_of_medicare_ratenew_avg_canonical_rateold_avg_canonical_ratemedicare_rate_pct_changecanonical_rate_pct_changenew_roid_countold_roid_count
3,902,096,239,283,128,7331.252.292,635.241,902.59-45.7%38.5%392,049435,194
-8,506,106,384,867,378,4301.482.423,072.3610,154.42-38.8%-69.7%662,036179,939
-2,865,465,467,459,569,3441.983.197,699.326,333.72-38.0%21.6%515,344458,754
3,376,187,909,306,580,7991.932.753,732.382,674.20-29.6%39.6%1,157,0731,251,804
6,037,342,850,284,539,6242.112.824,625.923,673.29-25.3%25.9%1,265,2111,369,266
-1,275,781,459,639,371,2022.283.044,872.945,665.74-25.0%-14.0%87,45797,319
-6,588,387,606,928,155,1692.33.0514,559.0013,056.75-24.5%11.5%1,243,3631,273,347
-7,225,588,104,346,557,7152.343.0914,639.5913,335.45-24.2%9.8%1,272,4961,285,084
7,750,147,370,859,442,4592.323.0514,600.0313,024.86-24.0%12.1%1,254,3751,312,136
-5,617,272,627,028,270,6392.252.959,031.368,322.84-23.8%8.5%725,342729,747
5,605,126,640,932,710,9302.441.9934,651.4126,129.3522.9%32.6%235,887323,065
-1,777,933,741,358,895,4302.162.87,994.967,777.83-22.8%2.8%1,136,6191,181,081
-7,304,296,722,942,665,7132.292.9115,381.3613,479.36-21.4%14.1%1,302,7421,386,853
1,164,822,038,571,945,2231.862.365,482.865,511.14-20.9%-0.5%436,296453,555
1,481,239,756,837,705,7682.332.886,466.1714,028.74-19.1%-53.9%832,000360,457
1,391,056,274,517,336,0752.463.039,545.478,425.45-18.8%13.3%1,013,1271,196,679
-4,944,049,946,733,699,7623.383.9412,784.9410,646.49-14.2%20.1%436,958451,143
-137,228,703,119,221,5022.031.86,245.116,063.8512.8%3.0%884,401851,903
-6,639,294,638,665,975,0962.282.613,501.085,641.09-12.3%-37.9%290,118410,080
5,170,047,179,706,197,7772.723.110,437.7611,809.14-12.2%-11.6%342,537307,821
-7,160,850,762,653,242,0952.62.929,974.1411,416.00-11.0%-12.6%328,694290,216
1,579,516,467,629,270,5772.672.979,785.289,743.09-10.2%0.4%279,803284,453
-7,995,682,717,897,123,0392.672.9215,060.6012,147.39-8.4%24.0%4,799,8665,106,336
6,974,535,101,123,239,1312.872.659,198.887,837.628.1%17.4%547,471583,345
-1,016,849,053,752,795,1502.813.059,662.0010,758.76-7.7%-10.2%387,166397,259
-7,572,382,112,705,938,0292.162.026,554.155,772.496.9%13.5%411,394424,312
-4,445,518,905,666,343,7972.162.0318,337.4614,297.726.3%28.3%183,602185,851
7,616,836,552,481,822,1752.42.269,807.318,258.196.1%18.8%4,041,6704,222,895
1,017,413,876,722,652,4242.262.138,718.797,315.356.0%19.2%3,717,7303,855,691
5,177,932,399,303,345,0461.941.836,733.205,857.745.7%14.9%1,500,2061,664,157
-4,138,824,164,451,705,1072.022.146,990.7510,889.59-5.6%-35.8%282,325337,700
-3,711,121,367,896,011,8332.422.317,533.386,730.675.0%11.9%2,580,1552,831,652
-434,992,428,366,718,7242.482.366,514.305,780.045.0%12.7%1,197,4191,310,748
-4,061,814,287,107,819,8042.272.383,648.814,269.90-4.8%-14.5%133,500179,439
-7,942,674,608,514,495,2822.122.228,364.637,367.15-4.3%13.5%1,046,6641,053,365
-4,564,247,599,614,740,6582.062.156,093.836,868.09-4.2%-11.3%506,348520,020
-1,205,712,746,611,102,7433.183.327,752.5910,407.50-4.0%-25.5%483,298538,619
5,781,103,079,387,890,6361.731.664,310.343,582.483.7%20.3%1,214,5291,203,453
-8,403,435,045,225,894,9541.911.985,488.346,842.79-3.6%-19.8%392,050420,092
1,222,051,438,589,625,0172.482.579,869.6712,541.82-3.6%-21.3%786,186991,273
515,753,131,988,643,1451.961.96,256.355,421.853.2%15.4%1,395,8861,251,379
-3,111,440,664,317,846,5561.851.87,846.137,072.992.9%10.9%225,701240,106
-7,973,680,817,747,944,9381.841.886,251.935,512.39-2.4%13.4%993,5501,002,368
-7,365,202,427,208,089,9852.242.198,762.127,954.842.3%10.1%627,011638,479
707,343,854,139,029,2551.881.926,549.295,837.89-2.2%12.2%1,026,0841,029,075
5,645,818,248,035,806,8611.921.887,826.619,226.361.8%-15.2%703,219770,350
-4,630,321,108,541,466,5711.771.747,225.408,393.661.6%-13.9%809,596892,136
7,900,428,585,805,602,8311.761.735,505.384,122.991.4%33.5%181,985210,107
8,611,629,356,743,080,9842.582.549,316.957,856.551.3%18.6%3,919,3864,114,148
-6,543,868,296,982,650,5192.572.5412,281.1810,987.111.3%11.8%2,464,2662,619,326

Showing 50 of 59 total rows

Click to see SQL
WITH
new AS (
SELECT
network_id,
AVG(canonical_rate_percent_of_medicare) AS avg_pct_of_medicare_rate,
AVG(canonical_rate) AS avg_canonical_rate,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY network_id
),
old AS (
SELECT
network_id,
AVG(canonical_rate_percent_of_medicare) AS avg_pct_of_medicare_rate,
AVG(canonical_rate) AS avg_canonical_rate,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY network_id
)
SELECT
network_id,
new.avg_pct_of_medicare_rate AS new_avg_pct_of_medicare_rate,
old.avg_pct_of_medicare_rate AS old_avg_pct_of_medicare_rate,
new.avg_canonical_rate AS new_avg_canonical_rate,
old.avg_canonical_rate AS old_avg_canonical_rate,
(new.avg_pct_of_medicare_rate - old.avg_pct_of_medicare_rate) / NULLIF(old.avg_pct_of_medicare_rate, 0) AS medicare_rate_pct_change,
(new.avg_canonical_rate - old.avg_canonical_rate) / NULLIF(old.avg_canonical_rate, 0) AS canonical_rate_pct_change,
new.roid_count AS new_roid_count,
old.roid_count AS old_roid_count
FROM new
JOIN old USING (network_id)
WHERE (
ABS((new.avg_pct_of_medicare_rate - old.avg_pct_of_medicare_rate) / NULLIF(old.avg_pct_of_medicare_rate, 0)) > 0.1
OR ABS((new.avg_canonical_rate - old.avg_canonical_rate) / NULLIF(old.avg_canonical_rate, 0)) > 0.1
) AND (
new.roid_count > 500 AND old.roid_count > 500
)
ORDER BY ABS(medicare_rate_pct_change) DESC

4. Large ROID Count Swings (>10% change)

By Service Line

Count: 9 categories with significant ROID count changes

service_linenew_roid_countold_roid_countroid_count_changeroid_count_pct_change
MSK45,505,15754,439,715-8,934,558-16.4%
Oncology8,590,0327,497,0291,093,00314.6%
ENT11,334,77013,233,544-1,898,774-14.3%
Dental370,136425,799-55,663-13.1%
Ophthalmology12,089,16413,802,176-1,713,012-12.4%
Gastrointestinal18,608,15721,014,376-2,406,219-11.5%
Transplant65,01672,833-7,817-10.7%
Reproductive7,688,3478,595,436-907,089-10.6%
Urology8,651,5309,671,884-1,020,354-10.5%
Click to see SQL
WITH
new AS (
SELECT
service_line,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY service_line
),
old AS (
SELECT
service_line,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY service_line
)
SELECT
service_line,
new.roid_count AS new_roid_count,
old.roid_count AS old_roid_count,
(new.roid_count - old.roid_count) AS roid_count_change,
(new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0) AS roid_count_pct_change
FROM new
JOIN old USING (service_line)
WHERE ABS((new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0)) > 0.1
ORDER BY ABS(roid_count_pct_change) DESC

By Provider Type

Count: 2 categories with significant ROID count changes

provider_typenew_roid_countold_roid_countroid_count_changeroid_count_pct_change
Laboratory3,535,4612,158,4931,376,96863.8%
ASC15,194,45125,049,884-9,855,433-39.3%
Click to see SQL
WITH
new AS (
SELECT
provider_type,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY provider_type
),
old AS (
SELECT
provider_type,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY provider_type
)
SELECT
provider_type,
new.roid_count AS new_roid_count,
old.roid_count AS old_roid_count,
(new.roid_count - old.roid_count) AS roid_count_change,
(new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0) AS roid_count_pct_change
FROM new
JOIN old USING (provider_type)
WHERE ABS((new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0)) > 0.1
ORDER BY ABS(roid_count_pct_change) DESC

By State

Count: 12 categories with significant ROID count changes

statenew_roid_countold_roid_countroid_count_changeroid_count_pct_change
SD1,379,8921,787,289-407,397-22.8%
ND1,080,8091,347,092-266,283-19.8%
MT1,643,6422,009,110-365,468-18.2%
AK504,206609,886-105,680-17.3%
VT423,941508,507-84,566-16.6%
WY695,031832,045-137,014-16.5%
DE705,421825,496-120,075-14.5%
IA4,763,0645,491,927-728,863-13.3%
UT1,763,3092,028,198-264,889-13.1%
NE2,954,8373,317,381-362,544-10.9%
KS4,748,8115,291,078-542,267-10.2%
MN6,927,1437,702,954-775,811-10.1%
Click to see SQL
WITH
new AS (
SELECT
state,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY state
),
old AS (
SELECT
state,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY state
)
SELECT
state,
new.roid_count AS new_roid_count,
old.roid_count AS old_roid_count,
(new.roid_count - old.roid_count) AS roid_count_change,
(new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0) AS roid_count_pct_change
FROM new
JOIN old USING (state)
WHERE ABS((new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0)) > 0.1
ORDER BY ABS(roid_count_pct_change) DESC

By Payer Network Name

Count: 25 categories with significant ROID count changes

payer_network_namenew_roid_countold_roid_countroid_count_changeroid_count_pct_change
Blue Cross Blue Shield of Maryland & DC (CareFirst) HMO662,036179,939482,097267.9%
Regence Blue Cross Blue Shield OR PPO832,000360,457471,543130.8%
Blue Cross Blue Shield of Montana Blue Preferred PPO290,118410,080-119,962-29.3%
EmblemHealth GHI / Anthem CBP235,887323,065-87,178-27.0%
Avera Health Plans Avera Health133,500179,439-45,939-25.6%
Sanford Health Plan PPO786,186991,273-205,087-20.7%
Anthem NH HMO335,159286,30948,85017.1%
MetroPlus Health Gold700,725838,418-137,693-16.4%
Wellmark Blue Cross Blue Shield SD PPO282,325337,700-55,375-16.4%
Cigna MO HMO379,525451,022-71,497-15.9%
WPS PPO1,013,1271,196,679-183,552-15.3%
Premera Blue Cross Alaska Heritage Network175,626207,106-31,480-15.2%
Anthem NH OPEN ACCESS364,781317,08147,70015.0%
Kaiser Permanente Kaiser Health Plan (HI)181,985210,107-28,122-13.4%
Anthem ME HMO328,694290,21638,47813.3%
Moda Health Connexus515,344458,75456,59012.3%
Blue Cross Blue Shield of Tennessee PPO1,395,8861,251,379144,50711.5%
Anthem ME Blue Choice PPO342,537307,82134,71611.3%
Blue Cross Blue Shield of North Dakota PPO321,165361,451-40,286-11.1%
Cigna VA HMO496,551556,617-60,066-10.8%
UnitedHealthcare HMO55,175,81861,644,316-6,468,498-10.5%
Anthem GA OPEN ACCESS1,738,5231,575,920162,60310.3%
Kaiser Permanente Kaiser Health Plan (CO)483,298538,619-55,321-10.3%
Blue Cross Blue Shield of Vermont PPO87,45797,319-9,862-10.1%
UnitedHealthcare Choice Plus57,213,71563,623,745-6,410,030-10.1%
Click to see SQL
WITH
new AS (
SELECT
payer_network_name,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY payer_network_name
),
old AS (
SELECT
payer_network_name,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY payer_network_name
)
SELECT
payer_network_name,
new.roid_count AS new_roid_count,
old.roid_count AS old_roid_count,
(new.roid_count - old.roid_count) AS roid_count_change,
(new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0) AS roid_count_pct_change
FROM new
JOIN old USING (payer_network_name)
WHERE ABS((new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0)) > 0.1
ORDER BY ABS(roid_count_pct_change) DESC

By Network + Canonical Rate Source (Check for New Pairs with 0 Rates)

Count: 10 categories with significant ROID count changes

payer_idpayer_namenetwork_namecanonical_rate_sourcen_oldn_new
791MotivHealth Insurance CompanyMotivNetpayer32,5940
317Tufts Health PlanHMOpayer1,0920
317Tufts Health PlanPPO MApayer2580
791MotivHealth Insurance CompanyMotivNetimputation1010
397Blue Cross Blue Shield of Rhode IslandPPOimputation13950
458Blue Cross Blue Shield of North DakotaPPOimputation3,11989
628Premera Blue CrossAlaska Heritage Networkimputation556534
42AnthemNH HMOimputation570586
53Blue Cross Blue Shield of OklahomaBlue Preferred PPOimputation668625
462Blue Cross Blue Shield of VermontPPOimputation4,0101,048
Click to see SQL
WITH
new AS (
SELECT
payer_id,
payer_name,
network_name,
canonical_rate_source,
count(distinct roid) AS n_new
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY 1,2,3,4
),
old AS (
SELECT
payer_id,
payer_name,
network_name,
canonical_rate_source,
count(distinct roid) AS n_old
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY 1,2,3,4
)
SELECT
payer_id,
payer_name,
network_name,
canonical_rate_source,
n_old,
COALESCE(n_new, 0) as n_new
FROM old
FULL OUTER JOIN new USING (payer_id, payer_name, network_name, canonical_rate_source)
ORDER BY COALESCE(n_new, 0) ASC
LIMIT 10

By Health System Name

Count: 131 categories with significant ROID count changes

provider_typehealth_system_namenew_roid_countold_roid_countroid_count_changeroid_count_pct_change
HospitalPAM Health127,423228,674-101,251-44.3%
HospitalCHRISTUS Health Shreveport - Bossier Health System138,14196,55941,58243.1%
ASCBaylor Scott & White Health74,069119,333-45,264-37.9%
ASCAMSURG362,557583,004-220,447-37.8%
HospitalTMC Health127,50993,33834,17136.6%
ASCTexas Health Resources66,699104,889-38,190-36.4%
ASCSurgery Partners439,584679,266-239,682-35.3%
HospitalAvera Health643,775969,890-326,115-33.6%
ASCVirtua Health94,971141,747-46,776-33.0%
ASCUnited Surgical Partners International2,027,6383,004,028-976,390-32.5%
ASCSCA Health817,7021,190,790-373,088-31.3%
ASCAmbulatory Surgical Centers of America71,434102,754-31,320-30.5%
HospitalErnest Health101,950146,508-44,558-30.4%
ASCInova82,288117,800-35,512-30.1%
ASCMemorial Hermann Health System88,405126,512-38,107-30.1%
HospitalUnityPoint Health Fort Dodge108,126153,281-45,155-29.5%
HospitalOakBend Medical Center Health System72,940103,041-30,101-29.2%
HospitalCHI St Alexius Health Bismarck131,340184,957-53,617-29.0%
HospitalLogan Health94,784133,093-38,309-28.8%
Physician GroupFranciscan Missionaries of Our Lady Health System98,566138,134-39,568-28.6%
HospitalFirstHealth of the Carolinas100,777140,080-39,303-28.1%
Physician GroupAlbany MED Health System212,411294,603-82,192-27.9%
Physician GroupBeth Israel Lahey Health119,960166,294-46,334-27.9%
HospitalEncompass Health Corporation820,7251,116,644-295,919-26.5%
Physician GroupJohn Muir Health76,979104,046-27,067-26.0%
Physician GroupBayCare Health System77,297104,235-26,938-25.8%
ASCDignity Health118,103159,183-41,080-25.8%
Physician GroupAurora Health Care134,939180,964-46,025-25.4%
Physician GroupKaleida Health96,592129,374-32,782-25.3%
HospitalBillings Clinic Health System233,997312,910-78,913-25.2%
HospitalMercyOne651,406869,378-217,972-25.1%
HospitalGreat Plains Health Alliance557,861727,103-169,242-23.3%
HospitalMayo Clinic165,754134,58831,16623.2%
HospitalCHI Saint Joseph Health236,230192,13644,09422.9%
Physician GroupAspirus Health237,511307,561-70,050-22.8%
HospitalHCA North Carolina Division180,535233,119-52,584-22.6%
Physician GroupUMass Memorial Health Care97,318123,643-26,325-21.3%
ASCHCA Surgery Center Division679,028860,938-181,910-21.1%
HospitalSanford Health715,011898,740-183,729-20.4%
Physician GroupSentara Health172,832215,924-43,092-20.0%
Physician GroupWellstar MCG Health82,530102,852-20,322-19.8%
Physician GroupCovenant Health92,438114,357-21,919-19.2%
HospitalOne Brooklyn Health System229,437283,799-54,362-19.2%
Physician GroupProvidence Health & Services - Oregon and Southwest Washington196,210164,72931,48119.1%
HospitalNorthwest Texas Healthcare System101,458125,174-23,716-18.9%
HospitalCentraCare Health System254,864313,673-58,809-18.7%
HospitalShannon Health157,948133,30024,64818.5%
Physician GroupDuke LifePoint Healthcare102,239124,731-22,492-18.0%
Physician GroupSalem Health104,14188,41015,73117.8%
HospitalHCA Continental Division - Wesley Healthcare93,184113,255-20,071-17.7%

Showing 50 of 131 total rows

Click to see SQL
WITH
new AS (
SELECT
provider_type,
health_system_name,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY 1,2
),
old AS (
SELECT
provider_type,
health_system_name,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY 1,2
)
SELECT
provider_type,
health_system_name,
new.roid_count AS new_roid_count,
old.roid_count AS old_roid_count,
(new.roid_count - old.roid_count) AS roid_count_change,
(new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0) AS roid_count_pct_change
FROM new
JOIN old USING (provider_type, health_system_name)
WHERE ABS((new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0)) > 0.1
AND (
new.roid_count > 100000 OR old.roid_count > 100000
)
ORDER BY ABS(roid_count_pct_change) DESC

By Canonical Rate Score

Count: 3 categories with significant ROID count changes

canonical_rate_scorenew_roid_countold_roid_countroid_count_changeroid_count_pct_change
3181,296,14983,808,13497,488,015116.3%
242,035,96922,264,85619,771,11388.8%
4127,692,004268,722,492-141,030,488-52.5%
Click to see SQL
WITH
new AS (
SELECT
canonical_rate_score,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY canonical_rate_score
),
old AS (
SELECT
canonical_rate_score,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY canonical_rate_score
)
SELECT
canonical_rate_score,
new.roid_count AS new_roid_count,
old.roid_count AS old_roid_count,
(new.roid_count - old.roid_count) AS roid_count_change,
(new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0) AS roid_count_pct_change
FROM new
JOIN old USING (canonical_rate_score)
WHERE ABS((new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0)) > 0.1
ORDER BY ABS(roid_count_pct_change) DESC

By Canonical Rate Score and Provider Type

Count: 12 categories with significant ROID count changes

provider_typecanonical_rate_scorenew_roid_countold_roid_countroid_count_changeroid_count_pct_change
ASC2174,837329,312-154,475-46.9%
ASC414,781,25524,487,408-9,706,153-39.6%
Hospital4108,442,836128,476,272-20,033,436-15.6%
Hospital358,842,61751,281,2237,561,39414.7%
Laboratory51,725,375952,334773,04181.2%
Laboratory4223,078141,84881,23057.3%
Laboratory31,102,616733,853368,76350.3%
Laboratory2484,392330,458153,93446.6%
Physician Group3121,112,19731,559,54089,552,657283.8%
Physician Group227,164,6687,902,22219,262,446243.8%
Physician Group41,265,107112,588,567-111,323,460-98.9%
Physician Group5929,642546,220383,42270.2%
Click to see SQL
WITH
new AS (
SELECT
provider_type,
canonical_rate_score,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY provider_type, canonical_rate_score
),
old AS (
SELECT
provider_type,
canonical_rate_score,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY provider_type, canonical_rate_score
)
SELECT
provider_type,
canonical_rate_score,
new.roid_count AS new_roid_count,
old.roid_count AS old_roid_count,
(new.roid_count - old.roid_count) AS roid_count_change,
(new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0) AS roid_count_pct_change
FROM new
JOIN old USING (provider_type, canonical_rate_score)
WHERE ABS((new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0)) > 0.1
ORDER BY provider_type, ABS(roid_count_pct_change) DESC

By Canonical Rate Class

Count: 2 categories with significant ROID count changes

canonical_rate_classnew_roid_countold_roid_countroid_count_changeroid_count_pct_change
Impute62,027,99479,160,748-17,132,754-21.6%
Transform24,960,53230,956,297-5,995,765-19.4%
Click to see SQL
WITH
new AS (
SELECT
canonical_rate_class,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY canonical_rate_class
),
old AS (
SELECT
canonical_rate_class,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY canonical_rate_class
)
SELECT
canonical_rate_class,
new.roid_count AS new_roid_count,
old.roid_count AS old_roid_count,
(new.roid_count - old.roid_count) AS roid_count_change,
(new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0) AS roid_count_pct_change
FROM new
JOIN old USING (canonical_rate_class)
WHERE ABS((new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0)) > 0.1
ORDER BY ABS(roid_count_pct_change) DESC

By Canonical Rate Source

Count: 1 categories with significant ROID count changes

canonical_rate_sourcenew_roid_countold_roid_countroid_count_changeroid_count_pct_change
imputation62,027,99479,160,748-17,132,754-21.6%
Click to see SQL
WITH
new AS (
SELECT
canonical_rate_source,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY canonical_rate_source
),
old AS (
SELECT
canonical_rate_source,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY canonical_rate_source
)
SELECT
canonical_rate_source,
new.roid_count AS new_roid_count,
old.roid_count AS old_roid_count,
(new.roid_count - old.roid_count) AS roid_count_change,
(new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0) AS roid_count_pct_change
FROM new
JOIN old USING (canonical_rate_source)
WHERE ABS((new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0)) > 0.1
ORDER BY ABS(roid_count_pct_change) DESC

By Canonical Contract Methodology

Count: 2 categories with significant ROID count changes

canonical_contract_methodologynew_roid_countold_roid_countroid_count_changeroid_count_pct_change
Per Diem4,148,7243,431,956716,76820.9%
Case Rate85,591,208104,246,229-18,655,021-17.9%
Click to see SQL
WITH
new AS (
SELECT
canonical_contract_methodology,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY canonical_contract_methodology
),
old AS (
SELECT
canonical_contract_methodology,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY canonical_contract_methodology
)
SELECT
canonical_contract_methodology,
new.roid_count AS new_roid_count,
old.roid_count AS old_roid_count,
(new.roid_count - old.roid_count) AS roid_count_change,
(new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0) AS roid_count_pct_change
FROM new
JOIN old USING (canonical_contract_methodology)
WHERE ABS((new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0)) > 0.1
ORDER BY ABS(roid_count_pct_change) DESC

By Canonical Crosswalk Method

Count: 5 categories with significant ROID count changes

canonical_crosswalk_methodnew_roid_countold_roid_countroid_count_changeroid_count_pct_change
Crosswalked From CSTM-ALL to APR-DRG726,342939,160-212,818-22.7%
Crosswalked From NDC to HCPCS841,0121,044,354-203,342-19.5%
Crosswalked From CSTM-ALL to MS-DRG611,444744,246-132,802-17.8%
Crosswalked From RC-FAMILY to MS-DRG752,632660,90091,73213.9%
Crosswalked From RC-FAMILY to APR-DRG964,179859,290104,88912.2%
Click to see SQL
WITH
new AS (
SELECT
canonical_crosswalk_method,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY canonical_crosswalk_method
),
old AS (
SELECT
canonical_crosswalk_method,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY canonical_crosswalk_method
)
SELECT
canonical_crosswalk_method,
new.roid_count AS new_roid_count,
old.roid_count AS old_roid_count,
(new.roid_count - old.roid_count) AS roid_count_change,
(new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0) AS roid_count_pct_change
FROM new
JOIN old USING (canonical_crosswalk_method)
WHERE ABS((new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0)) > 0.1
ORDER BY ABS(roid_count_pct_change) DESC

By Canonical Gross Charge Type

Count: 2 categories with significant ROID count changes

canonical_gross_charge_typenew_roid_countold_roid_countroid_count_changeroid_count_pct_change
mrf_gross_charge_cbsa_median18,310,73932,430,284-14,119,545-43.5%
komodo_gross_charge_state_median10,893,8789,514,7421,379,13614.5%
Click to see SQL
WITH
new AS (
SELECT
canonical_gross_charge_type,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_3_0.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY canonical_gross_charge_type
),
old AS (
SELECT
canonical_gross_charge_type,
COUNT(DISTINCT roid) AS roid_count
FROM tq_dev.internal_dev_csong_cld_v2_2_2.prod_combined_abridged
WHERE canonical_rate_score > 1
AND network_type != 'NARROW'
AND network_class = 'Commercial'
GROUP BY canonical_gross_charge_type
)
SELECT
canonical_gross_charge_type,
new.roid_count AS new_roid_count,
old.roid_count AS old_roid_count,
(new.roid_count - old.roid_count) AS roid_count_change,
(new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0) AS roid_count_pct_change
FROM new
JOIN old USING (canonical_gross_charge_type)
WHERE ABS((new.roid_count - old.roid_count) * 1.0 / NULLIF(old.roid_count, 0)) > 0.1
ORDER BY ABS(roid_count_pct_change) DESC