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_type | bill_type | new_distinct_roids | old_distinct_roids | new_distinct_networks | old_distinct_networks | new_distinct_providers | old_distinct_providers | new_distinct_billing_codes | old_distinct_billing_codes |
|---|---|---|---|---|---|---|---|---|---|
| ASC | Outpatient | 15,194,451 | 25,049,884 | 143 | 139 | 5,590 | 5,583 | 3,369 | 3,371 |
| Physician Group | Professional | 150,471,614 | 152,596,549 | 167 | 167 | 17,335 | 16,500 | 3,781 | 2,838 |
| Hospital | Inpatient | 41,786,024 | 42,273,347 | 167 | 168 | 5,594 | 5,571 | 1,717 | 1,716 |
| Laboratory | Professional | 3,535,461 | 2,158,493 | 146 | 149 | 696 | 718 | 917 | 917 |
| Imaging Center | Professional | 2,980,187 | 3,028,849 | 150 | 151 | 2,976 | 2,987 | 172 | 172 |
| Hospital | Outpatient | 164,813,213 | 176,751,052 | 167 | 168 | 5,647 | 5,620 | 7,064 | 7,064 |
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_type | provider_id | new_avg_pct_of_medicare_rate | old_avg_pct_of_medicare_rate | new_avg_canonical_rate | old_avg_canonical_rate | medicare_rate_pct_change | canonical_rate_pct_change | new_roid_count | old_roid_count |
|---|---|---|---|---|---|---|---|---|---|
| Outpatient | 9732 | 2.86 | 0.65 | 7,973.48 | 2,834.54 | 342.7% | 181.3% | 10,985 | 10,281 |
| Inpatient | 6076 | 6.62 | 1.75 | 111,634.92 | 32,695.22 | 278.3% | 241.4% | 101 | 1,497 |
| Outpatient | 23549 | 5.3 | 1.53 | 8,180.79 | 1,530.04 | 245.9% | 434.7% | 876 | 644 |
| Outpatient | 9960 | 3.02 | 0.9 | 7,057.04 | 1,252.20 | 234.3% | 463.6% | 8,130 | 11,494 |
| Inpatient | 5581 | 3.61 | 1.1 | 53,993.87 | 19,401.32 | 228.7% | 178.3% | 1,805 | 3,753 |
| Inpatient | 1592 | 5.49 | 1.75 | 58,349.67 | 29,629.84 | 213.0% | 96.9% | 482 | 2,559 |
| Outpatient | 26424 | 3 | 0.97 | 569.37 | 706.45 | 209.2% | -19.4% | 1,562 | 11,456 |
| Professional | -7698044148695228947 | 3.32 | 1.09 | 2,013.67 | 193.25 | 204.4% | 942.0% | 3,634 | 2,069 |
| Outpatient | 30859 | 2.01 | 0.66 | 1,912.05 | 877.40 | 203.9% | 117.9% | 513 | 4,051 |
| Inpatient | 9933 | 3.59 | 1.18 | 65,312.12 | 18,760.62 | 203.5% | 248.1% | 13,008 | 5,926 |
| Outpatient | 24355 | 2.17 | 0.72 | 1,067.68 | 979.41 | 202.9% | 9.0% | 562 | 3,128 |
| Inpatient | 6069 | 7.19 | 2.42 | 115,494.77 | 45,727.48 | 197.6% | 152.6% | 321 | 7,659 |
| Outpatient | 31614 | 5.69 | 1.92 | 2,348.41 | 556.02 | 195.6% | 322.4% | 902 | 6,140 |
| Outpatient | 6713 | 10.91 | 3.98 | 4,991.55 | 4,402.45 | 174.3% | 13.4% | 4,802 | 12,018 |
| Outpatient | 4162 | 7.64 | 2.86 | 5,977.86 | 2,842.82 | 166.8% | 110.3% | 3,981 | 8,774 |
| Outpatient | 1910 | 10.46 | 3.92 | 29,892.28 | 11,499.67 | 166.7% | 159.9% | 22,054 | 28,997 |
| Outpatient | 25872 | 2.33 | 0.87 | 1,740.06 | 755.14 | 166.2% | 130.4% | 517 | 6,263 |
| Outpatient | 22889 | 2.06 | 0.78 | 1,008.00 | 629.76 | 164.6% | 60.1% | 543 | 6,764 |
| Professional | 5730680757409679385 | 2.54 | 0.98 | 1,801.78 | 237.80 | 159.3% | 657.7% | 4,172 | 2,644 |
| Outpatient | 28370 | 1.68 | 0.65 | 2,768.34 | 1,226.79 | 159.1% | 125.7% | 920 | 3,268 |
| Inpatient | 6713 | 6.18 | 2.41 | 75,760.69 | 41,747.74 | 156.0% | 81.5% | 217 | 4,374 |
| Outpatient | 26527 | 2.24 | 0.89 | 784.50 | 812.71 | 152.8% | -3.5% | 654 | 4,037 |
| Outpatient | 22714 | 2.1 | 0.84 | 468.16 | 502.72 | 151.3% | -6.9% | 3,489 | 13,903 |
| Professional | -4484641617725774088 | 2.42 | 0.96 | 2,005.04 | 173.32 | 151.0% | 1056.8% | 3,606 | 2,166 |
| Outpatient | 5764 | 1.65 | 0.67 | 734.59 | 693.37 | 147.9% | 5.9% | 2,773 | 9,601 |
| Professional | -1938068338601073767 | 2.35 | 0.96 | 2,109.42 | 173.36 | 144.8% | 1116.8% | 3,406 | 1,962 |
| Outpatient | 25304 | 2.54 | 1.04 | 865.60 | 855.30 | 144.7% | 1.2% | 524 | 5,437 |
| Outpatient | 32398 | 2.4 | 0.99 | 1,515.51 | 998.28 | 143.5% | 51.8% | 706 | 2,882 |
| Outpatient | 21857 | 1.95 | 0.81 | 446.34 | 509.94 | 140.9% | -12.5% | 4,392 | 16,321 |
| Outpatient | 26038 | 2.3 | 0.96 | 1,955.66 | 1,093.04 | 140.3% | 78.9% | 577 | 4,849 |
| Outpatient | 8981 | 1.12 | 0.47 | 297.02 | 472.62 | 139.9% | -37.2% | 2,250 | 9,758 |
| Outpatient | 28836 | 2.15 | 0.91 | 5,781.50 | 1,750.43 | 135.7% | 230.3% | 940 | 2,488 |
| Outpatient | 9488 | 0.92 | 0.39 | 527.63 | 453.36 | 134.4% | 16.4% | 2,366 | 8,668 |
| Inpatient | 6558 | 6.14 | 2.62 | 103,457.00 | 44,508.25 | 134.2% | 132.4% | 615 | 2,824 |
| Outpatient | 28631 | 1.83 | 0.8 | 1,447.87 | 1,047.38 | 128.4% | 38.2% | 507 | 2,462 |
| Outpatient | 10266 | 1.12 | 0.49 | 300.72 | 415.61 | 126.7% | -27.6% | 2,251 | 9,212 |
| Outpatient | 10661 | 1.12 | 0.49 | 299.36 | 413.14 | 126.6% | -27.5% | 2,252 | 9,266 |
| Professional | -4494441184012979231 | 2.67 | 1.18 | 1,972.49 | 222.12 | 126.6% | 788.0% | 1,240 | 697 |
| Outpatient | 5571 | 5.02 | 2.22 | 7,511.40 | 3,732.50 | 125.9% | 101.2% | 13,590 | 25,530 |
| Outpatient | 20379 | 6.52 | 2.89 | 3,840.66 | 1,564.44 | 125.5% | 145.5% | 909 | 3,843 |
| Outpatient | 8921 | 2.54 | 1.13 | 1,053.65 | 1,042.39 | 125.5% | 1.1% | 2,908 | 7,696 |
| Professional | 1873799107203658695 | 2.18 | 0.97 | 1,758.85 | 247.87 | 125.5% | 609.6% | 4,281 | 2,726 |
| Professional | -3972253185612817143 | 3.61 | 1.61 | 969.68 | 196.86 | 124.5% | 392.6% | 1,028 | 13,119 |
| Professional | 3895627573700207023 | 2.27 | 1.01 | 1,688.11 | 233.76 | 124.4% | 622.2% | 1,486 | 932 |
| Outpatient | 8365 | 1.12 | 0.5 | 301.38 | 436.10 | 123.1% | -30.9% | 2,245 | 8,625 |
| Outpatient | 25915 | 1.89 | 0.85 | 423.28 | 506.10 | 122.1% | -16.4% | 1,860 | 5,468 |
| Professional | -8952390584130972734 | 2.16 | 0.97 | 1,731.28 | 245.18 | 122.1% | 606.1% | 4,353 | 2,778 |
| Outpatient | 28399 | 1.63 | 0.74 | 2,531.85 | 1,141.38 | 120.4% | 121.8% | 614 | 2,790 |
| Outpatient | 22166 | 1.49 | 0.68 | 1,729.12 | 724.33 | 119.8% | 138.7% | 504 | 5,282 |
| Outpatient | 8922 | 1.96 | 0.89 | 5,799.71 | 1,899.05 | 119.7% | 205.4% | 9,340 | 15,868 |
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_id | provider_id | new_avg_pct_of_medicare_rate | old_avg_pct_of_medicare_rate | new_avg_canonical_rate | old_avg_canonical_rate | medicare_rate_pct_change | canonical_rate_pct_change | new_roid_count | old_roid_count |
|---|---|---|---|---|---|---|---|---|---|
| 4,988,414,509,075,400,581 | 5571 | 5.93 | 1.3 | 9,143.47 | 8,035.47 | 356.2% | 13.8% | 1,854 | 7,719 |
| -2,162,498,661,799,343,237 | 8981695266597257781 | 2.92 | 0.68 | 105.03 | 59.98 | 331.7% | 75.1% | 636 | 631 |
| 8,361,580,493,441,765,265 | 1910 | 7.23 | 1.79 | 21,087.94 | 2,015.35 | 303.5% | 946.4% | 4,790 | 6,524 |
| 4,988,414,509,075,400,581 | 31836 | 5.27 | 1.33 | 8,171.80 | 1,851.16 | 295.1% | 341.4% | 875 | 505 |
| 5,075,764,097,723,629,059 | 5473745582902726561 | 3.5 | 0.91 | 1,645.28 | 255.32 | 285.1% | 544.4% | 1,591 | 1,119 |
| -558,178,834,365,778,978 | 5473745582902726561 | 3.5 | 0.91 | 1,645.28 | 255.32 | 285.1% | 544.4% | 1,591 | 1,119 |
| -2,162,498,661,799,343,237 | 9732 | 2.42 | 0.65 | 9,986.69 | 2,837.10 | 274.2% | 252.0% | 5,983 | 5,143 |
| 4,988,414,509,075,400,581 | 28686 | 5.34 | 1.45 | 8,163.63 | 1,492.65 | 268.3% | 446.9% | 879 | 850 |
| -2,162,498,661,799,343,237 | 3047 | 2.72 | 0.74 | 17,318.79 | 882.12 | 267.0% | 1863.3% | 5,431 | 787 |
| -2,162,498,661,799,343,237 | 24599 | 2.53 | 0.71 | 1,297.40 | 534.61 | 253.9% | 142.7% | 2,222 | 838 |
| -2,162,498,661,799,343,237 | 6713 | 12.56 | 3.56 | 9,417.44 | 14,850.17 | 252.9% | -36.6% | 1,258 | 4,942 |
| -3,776,001,016,975,145,508 | 6713 | 11.21 | 3.2 | 10,336.72 | 16,218.06 | 250.2% | -36.3% | 1,087 | 4,940 |
| 5,075,764,097,723,629,059 | -8612629535985160731 | 3 | 0.86 | 2,160.72 | 158.09 | 249.6% | 1266.8% | 1,110 | 649 |
| -558,178,834,365,778,978 | -8612629535985160731 | 3 | 0.86 | 2,160.72 | 158.09 | 249.6% | 1266.8% | 1,110 | 649 |
| 4,988,414,509,075,400,581 | 23549 | 5.3 | 1.53 | 8,180.79 | 1,530.04 | 245.9% | 434.7% | 876 | 644 |
| -2,162,498,661,799,343,237 | 713 | 2.53 | 0.73 | 2,615.38 | 521.46 | 245.2% | 401.6% | 3,198 | 502 |
| 8,361,580,493,441,765,265 | 4023 | 4.84 | 1.44 | 20,665.44 | 15,038.59 | 236.4% | 37.4% | 7,685 | 3,173 |
| -3,063,756,195,086,079,598 | 9842 | 5.41 | 1.61 | 22,178.21 | 28,064.91 | 236.1% | -21.0% | 6,459 | 2,299 |
| -2,162,498,661,799,343,237 | 3648 | 4.95 | 1.49 | 12,174.68 | 3,010.96 | 232.4% | 304.3% | 5,188 | 5,949 |
| -7,940,170,945,989,807,859 | 6713 | 10.61 | 3.19 | 8,014.64 | 14,337.07 | 232.4% | -44.1% | 1,734 | 5,544 |
| 5,075,764,097,723,629,059 | 2118729262235231070 | 3 | 0.9 | 2,214.92 | 163.29 | 232.2% | 1256.4% | 1,081 | 619 |
| -558,178,834,365,778,978 | 2118729262235231070 | 3 | 0.9 | 2,214.92 | 163.29 | 232.2% | 1256.4% | 1,081 | 619 |
| 5,075,764,097,723,629,059 | 5651548239953530517 | 3.08 | 0.93 | 1,908.13 | 160.18 | 231.8% | 1091.2% | 1,274 | 768 |
| -558,178,834,365,778,978 | 5651548239953530517 | 3.08 | 0.93 | 1,908.13 | 160.18 | 231.8% | 1091.2% | 1,274 | 768 |
| -6,972,129,921,516,377,126 | 6354 | 4.1 | 1.25 | 12,740.21 | 847.69 | 229.4% | 1402.9% | 5,629 | 4,453 |
| -2,162,498,661,799,343,237 | 4343 | 1.84 | 0.56 | 1,927.31 | 171.60 | 228.6% | 1023.2% | 3,791 | 574 |
| -558,178,834,365,778,978 | 6902590622312144885 | 2.94 | 0.91 | 1,597.68 | 264.47 | 224.0% | 504.1% | 1,637 | 1,124 |
| 5,075,764,097,723,629,059 | 6902590622312144885 | 2.94 | 0.91 | 1,597.68 | 264.47 | 224.0% | 504.1% | 1,637 | 1,124 |
| -2,162,498,661,799,343,237 | 31643 | 2.34 | 0.73 | 2,075.11 | 534.41 | 221.9% | 288.3% | 2,541 | 826 |
| -4,541,460,228,936,150,437 | 5497648929473393777 | 3.65 | 1.15 | 2,065.01 | 210.61 | 218.7% | 880.5% | 1,188 | 667 |
| -2,162,498,661,799,343,237 | 1317 | 3.4 | 1.07 | 14,880.79 | 6,043.47 | 217.1% | 146.2% | 8,298 | 6,661 |
| -558,178,834,365,778,978 | -4042515220149244083 | 3.03 | 0.96 | 2,108.36 | 174.90 | 214.9% | 1105.4% | 1,144 | 650 |
| 5,075,764,097,723,629,059 | -4042515220149244083 | 3.03 | 0.96 | 2,108.36 | 174.90 | 214.9% | 1105.4% | 1,144 | 650 |
| 5,075,764,097,723,629,059 | -7698044148695228947 | 3.3 | 1.06 | 2,010.30 | 187.16 | 211.7% | 974.1% | 1,211 | 689 |
| -558,178,834,365,778,978 | -7698044148695228947 | 3.3 | 1.06 | 2,010.30 | 187.16 | 211.7% | 974.1% | 1,211 | 689 |
| 4,281,965,180,796,802,413 | 5430 | 1.94 | 0.63 | 1,834.91 | 1,327.50 | 209.4% | 38.2% | 816 | 3,895 |
| 8,361,580,493,441,765,265 | 5430 | 1.94 | 0.63 | 1,834.91 | 1,327.50 | 209.4% | 38.2% | 816 | 3,895 |
| 4,988,414,509,075,400,581 | 29705 | 5.44 | 1.77 | 8,200.58 | 1,382.42 | 207.5% | 493.2% | 871 | 560 |
| -2,162,498,661,799,343,237 | 9858 | 3.14 | 1.04 | 22,967.05 | 745.21 | 200.6% | 2982.0% | 4,379 | 1,712 |
| 3,973,810,847,438,814,798 | 1910 | 15.54 | 5.17 | 49,267.44 | 26,697.24 | 200.4% | 84.5% | 3,541 | 5,923 |
| -558,178,834,365,778,978 | 8188998856188051201 | 2.72 | 0.91 | 1,786.33 | 230.38 | 200.1% | 675.4% | 1,405 | 912 |
| 5,075,764,097,723,629,059 | 8188998856188051201 | 2.72 | 0.91 | 1,786.33 | 230.38 | 200.1% | 675.4% | 1,405 | 912 |
| -558,178,834,365,778,978 | 5497648929473393777 | 3.15 | 1.06 | 2,045.99 | 192.10 | 198.2% | 965.1% | 1,187 | 665 |
| 5,075,764,097,723,629,059 | 5497648929473393777 | 3.15 | 1.06 | 2,045.99 | 192.10 | 198.2% | 965.1% | 1,187 | 665 |
| 2,039,367,776,086,447,454 | 9858 | 3.15 | 1.06 | 21,056.67 | 758.33 | 197.3% | 2676.7% | 4,845 | 1,716 |
| -2,162,498,661,799,343,237 | 1184 | 3.99 | 1.35 | 14,630.12 | 3,614.81 | 196.1% | 304.7% | 6,919 | 4,736 |
| -7,995,682,717,897,123,039 | 23135 | 2.58 | 0.87 | 1,962.90 | 741.52 | 195.6% | 164.7% | 775 | 849 |
| 4,281,965,180,796,802,413 | 4023 | 4.04 | 1.37 | 17,651.95 | 13,736.66 | 194.6% | 28.5% | 7,685 | 3,173 |
| -4,541,460,228,936,150,437 | -8612629535985160731 | 3.4 | 1.16 | 2,000.78 | 212.77 | 192.3% | 840.4% | 1,228 | 707 |
| -2,162,498,661,799,343,237 | 1910 | 14.35 | 4.92 | 45,972.91 | 25,573.92 | 191.3% | 79.8% | 3,772 | 5,797 |
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_id | provider_id | bill_type | new_avg_pct_of_medicare_rate | old_avg_pct_of_medicare_rate | new_avg_canonical_rate | old_avg_canonical_rate | medicare_rate_pct_change | canonical_rate_pct_change | new_roid_count | old_roid_count |
|---|---|---|---|---|---|---|---|---|---|---|
| 4,988,414,509,075,400,581 | 5571 | Outpatient | 5.93 | 1.21 | 9,143.47 | 1,918.72 | 390.9% | 376.5% | 1,854 | 6,043 |
| -2,162,498,661,799,343,237 | 8981695266597257781 | Professional | 2.92 | 0.68 | 105.03 | 59.98 | 331.7% | 75.1% | 636 | 631 |
| 8,361,580,493,441,765,265 | 1910 | Outpatient | 7.24 | 1.78 | 20,787.22 | 1,771.01 | 305.9% | 1073.7% | 4,764 | 6,492 |
| -2,162,498,661,799,343,237 | 1317 | Outpatient | 3.93 | 0.97 | 13,151.22 | 674.64 | 305.5% | 1849.4% | 6,582 | 4,945 |
| -3,776,001,016,975,145,508 | 6076 | Inpatient | 7.11 | 1.76 | 121,350.48 | 33,163.45 | 305.0% | 265.9% | 91 | 1,457 |
| 8,361,580,493,441,765,265 | 4023 | Outpatient | 5.83 | 1.47 | 18,931.90 | 1,217.32 | 295.5% | 1455.2% | 5,969 | 1,457 |
| 4,988,414,509,075,400,581 | 31836 | Outpatient | 5.27 | 1.33 | 8,171.80 | 1,851.16 | 295.1% | 341.4% | 875 | 505 |
| 5,075,764,097,723,629,059 | 5473745582902726561 | Professional | 3.5 | 0.91 | 1,645.28 | 255.32 | 285.1% | 544.4% | 1,591 | 1,119 |
| -558,178,834,365,778,978 | 5473745582902726561 | Professional | 3.5 | 0.91 | 1,645.28 | 255.32 | 285.1% | 544.4% | 1,591 | 1,119 |
| -2,162,498,661,799,343,237 | 3047 | Outpatient | 2.81 | 0.74 | 6,335.15 | 882.12 | 279.0% | 618.2% | 3,870 | 787 |
| -6,293,294,949,651,930,973 | 1964 | Outpatient | 5.28 | 1.41 | 18,050.29 | 17,269.36 | 273.4% | 4.5% | 4,340 | 1,550 |
| -2,162,498,661,799,343,237 | 9732 | Outpatient | 2.41 | 0.65 | 9,038.46 | 2,837.10 | 272.0% | 218.6% | 5,881 | 5,143 |
| 4,988,414,509,075,400,581 | 28686 | Outpatient | 5.34 | 1.45 | 8,163.63 | 1,492.65 | 268.3% | 446.9% | 879 | 850 |
| 5,373,876,635,451,223,842 | 9933 | Inpatient | 4.5 | 1.23 | 74,006.75 | 25,664.83 | 265.0% | 188.4% | 780 | 152 |
| -6,972,129,921,516,377,126 | 9933 | Inpatient | 4.5 | 1.23 | 74,006.75 | 25,664.83 | 265.0% | 188.4% | 780 | 152 |
| -3,063,756,195,086,079,598 | 9842 | Outpatient | 6.82 | 1.9 | 16,468.32 | 605.77 | 259.6% | 2618.6% | 4,742 | 583 |
| 4,988,414,509,075,400,581 | 5581 | Inpatient | 3.74 | 1.04 | 56,340.90 | 20,052.27 | 258.1% | 181.0% | 1,716 | 1,623 |
| -2,162,498,661,799,343,237 | 24599 | Outpatient | 2.53 | 0.71 | 1,297.40 | 534.61 | 253.9% | 142.7% | 2,222 | 838 |
| -558,178,834,365,778,978 | -8612629535985160731 | Professional | 3 | 0.86 | 2,160.72 | 158.09 | 249.6% | 1266.8% | 1,110 | 649 |
| 5,075,764,097,723,629,059 | -8612629535985160731 | Professional | 3 | 0.86 | 2,160.72 | 158.09 | 249.6% | 1266.8% | 1,110 | 649 |
| 4,988,414,509,075,400,581 | 23549 | Outpatient | 5.3 | 1.53 | 8,180.79 | 1,530.04 | 245.9% | 434.7% | 876 | 644 |
| -2,162,498,661,799,343,237 | 713 | Outpatient | 2.53 | 0.73 | 2,615.38 | 521.46 | 245.2% | 401.6% | 3,198 | 502 |
| -2,162,498,661,799,343,237 | 3546 | Inpatient | 3.73 | 1.1 | 45,157.74 | 8,634.57 | 238.4% | 423.0% | 511 | 39 |
| -2,162,498,661,799,343,237 | 3648 | Outpatient | 5.01 | 1.49 | 12,145.47 | 2,999.48 | 236.0% | 304.9% | 5,115 | 5,939 |
| 5,075,764,097,723,629,059 | 2118729262235231070 | Professional | 3 | 0.9 | 2,214.92 | 163.29 | 232.2% | 1256.4% | 1,081 | 619 |
| -558,178,834,365,778,978 | 2118729262235231070 | Professional | 3 | 0.9 | 2,214.92 | 163.29 | 232.2% | 1256.4% | 1,081 | 619 |
| 5,075,764,097,723,629,059 | 5651548239953530517 | Professional | 3.08 | 0.93 | 1,908.13 | 160.18 | 231.8% | 1091.2% | 1,274 | 768 |
| -558,178,834,365,778,978 | 5651548239953530517 | Professional | 3.08 | 0.93 | 1,908.13 | 160.18 | 231.8% | 1091.2% | 1,274 | 768 |
| -6,972,129,921,516,377,126 | 6354 | Outpatient | 4.11 | 1.25 | 12,743.48 | 841.59 | 229.8% | 1414.2% | 5,620 | 4,450 |
| -6,588,387,606,928,155,169 | 926 | Outpatient | 5.76 | 1.75 | 5,672.71 | 563.16 | 229.6% | 907.3% | 881 | 613 |
| -2,162,498,661,799,343,237 | 4343 | Outpatient | 1.84 | 0.56 | 1,912.70 | 163.30 | 229.3% | 1071.3% | 3,784 | 573 |
| 4,281,965,180,796,802,413 | 4023 | Outpatient | 4.83 | 1.47 | 15,728.68 | 1,217.32 | 228.0% | 1192.1% | 5,969 | 1,457 |
| -3,776,001,016,975,145,508 | 6713 | Outpatient | 11.54 | 3.52 | 6,661.05 | 5,043.44 | 227.4% | 32.1% | 1,025 | 3,465 |
| 8,361,580,493,441,765,265 | 9933 | Inpatient | 3.73 | 1.15 | 64,041.45 | 17,277.53 | 224.2% | 270.7% | 891 | 112 |
| 4,281,965,180,796,802,413 | 9933 | Inpatient | 3.73 | 1.15 | 64,041.45 | 17,277.53 | 224.2% | 270.7% | 891 | 112 |
| -558,178,834,365,778,978 | 6902590622312144885 | Professional | 2.94 | 0.91 | 1,597.68 | 264.47 | 224.0% | 504.1% | 1,637 | 1,124 |
| 5,075,764,097,723,629,059 | 6902590622312144885 | Professional | 2.94 | 0.91 | 1,597.68 | 264.47 | 224.0% | 504.1% | 1,637 | 1,124 |
| -2,162,498,661,799,343,237 | 6713 | Outpatient | 12.93 | 4.01 | 5,752.15 | 4,768.46 | 222.2% | 20.6% | 1,191 | 3,564 |
| -2,162,498,661,799,343,237 | 31643 | Outpatient | 2.34 | 0.73 | 2,075.11 | 534.41 | 221.9% | 288.3% | 2,541 | 826 |
| -3,776,001,016,975,145,508 | 1592 | Inpatient | 5.94 | 1.86 | 63,024.52 | 31,787.21 | 218.9% | 98.3% | 238 | 1,306 |
| -4,541,460,228,936,150,437 | 5497648929473393777 | Professional | 3.65 | 1.15 | 2,065.01 | 210.61 | 218.7% | 880.5% | 1,188 | 667 |
| -558,178,834,365,778,978 | -4042515220149244083 | Professional | 3.03 | 0.96 | 2,108.36 | 174.90 | 214.9% | 1105.4% | 1,144 | 650 |
| 5,075,764,097,723,629,059 | -4042515220149244083 | Professional | 3.03 | 0.96 | 2,108.36 | 174.90 | 214.9% | 1105.4% | 1,144 | 650 |
| 4,281,965,180,796,802,413 | 5430 | Outpatient | 1.95 | 0.62 | 1,220.80 | 1,215.86 | 214.0% | 0.4% | 789 | 3,870 |
| 8,361,580,493,441,765,265 | 5430 | Outpatient | 1.95 | 0.62 | 1,220.80 | 1,215.86 | 214.0% | 0.4% | 789 | 3,870 |
| 5,075,764,097,723,629,059 | -7698044148695228947 | Professional | 3.3 | 1.06 | 2,010.30 | 187.16 | 211.7% | 974.1% | 1,211 | 689 |
| -558,178,834,365,778,978 | -7698044148695228947 | Professional | 3.3 | 1.06 | 2,010.30 | 187.16 | 211.7% | 974.1% | 1,211 | 689 |
| -7,940,170,945,989,807,859 | 6713 | Outpatient | 10.79 | 3.47 | 5,218.29 | 4,138.84 | 211.2% | 26.1% | 1,666 | 4,069 |
| -8,389,359,264,395,369,979 | 1106 | Inpatient | 5.23 | 1.7 | 95,741.70 | 30,213.26 | 208.6% | 216.9% | 1,605 | 1,708 |
| -2,162,498,661,799,343,237 | 9858 | Outpatient | 3.21 | 1.04 | 6,249.50 | 745.21 | 207.7% | 738.6% | 2,751 | 1,712 |
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_id | new_avg_pct_of_medicare_rate | old_avg_pct_of_medicare_rate | new_avg_canonical_rate | old_avg_canonical_rate | medicare_rate_pct_change | canonical_rate_pct_change | new_roid_count | old_roid_count |
|---|---|---|---|---|---|---|---|---|
| 3,902,096,239,283,128,733 | 1.25 | 2.29 | 2,635.24 | 1,902.59 | -45.7% | 38.5% | 392,049 | 435,194 |
| -8,506,106,384,867,378,430 | 1.48 | 2.42 | 3,072.36 | 10,154.42 | -38.8% | -69.7% | 662,036 | 179,939 |
| -2,865,465,467,459,569,344 | 1.98 | 3.19 | 7,699.32 | 6,333.72 | -38.0% | 21.6% | 515,344 | 458,754 |
| 3,376,187,909,306,580,799 | 1.93 | 2.75 | 3,732.38 | 2,674.20 | -29.6% | 39.6% | 1,157,073 | 1,251,804 |
| 6,037,342,850,284,539,624 | 2.11 | 2.82 | 4,625.92 | 3,673.29 | -25.3% | 25.9% | 1,265,211 | 1,369,266 |
| -1,275,781,459,639,371,202 | 2.28 | 3.04 | 4,872.94 | 5,665.74 | -25.0% | -14.0% | 87,457 | 97,319 |
| -6,588,387,606,928,155,169 | 2.3 | 3.05 | 14,559.00 | 13,056.75 | -24.5% | 11.5% | 1,243,363 | 1,273,347 |
| -7,225,588,104,346,557,715 | 2.34 | 3.09 | 14,639.59 | 13,335.45 | -24.2% | 9.8% | 1,272,496 | 1,285,084 |
| 7,750,147,370,859,442,459 | 2.32 | 3.05 | 14,600.03 | 13,024.86 | -24.0% | 12.1% | 1,254,375 | 1,312,136 |
| -5,617,272,627,028,270,639 | 2.25 | 2.95 | 9,031.36 | 8,322.84 | -23.8% | 8.5% | 725,342 | 729,747 |
| 5,605,126,640,932,710,930 | 2.44 | 1.99 | 34,651.41 | 26,129.35 | 22.9% | 32.6% | 235,887 | 323,065 |
| -1,777,933,741,358,895,430 | 2.16 | 2.8 | 7,994.96 | 7,777.83 | -22.8% | 2.8% | 1,136,619 | 1,181,081 |
| -7,304,296,722,942,665,713 | 2.29 | 2.91 | 15,381.36 | 13,479.36 | -21.4% | 14.1% | 1,302,742 | 1,386,853 |
| 1,164,822,038,571,945,223 | 1.86 | 2.36 | 5,482.86 | 5,511.14 | -20.9% | -0.5% | 436,296 | 453,555 |
| 1,481,239,756,837,705,768 | 2.33 | 2.88 | 6,466.17 | 14,028.74 | -19.1% | -53.9% | 832,000 | 360,457 |
| 1,391,056,274,517,336,075 | 2.46 | 3.03 | 9,545.47 | 8,425.45 | -18.8% | 13.3% | 1,013,127 | 1,196,679 |
| -4,944,049,946,733,699,762 | 3.38 | 3.94 | 12,784.94 | 10,646.49 | -14.2% | 20.1% | 436,958 | 451,143 |
| -137,228,703,119,221,502 | 2.03 | 1.8 | 6,245.11 | 6,063.85 | 12.8% | 3.0% | 884,401 | 851,903 |
| -6,639,294,638,665,975,096 | 2.28 | 2.61 | 3,501.08 | 5,641.09 | -12.3% | -37.9% | 290,118 | 410,080 |
| 5,170,047,179,706,197,777 | 2.72 | 3.1 | 10,437.76 | 11,809.14 | -12.2% | -11.6% | 342,537 | 307,821 |
| -7,160,850,762,653,242,095 | 2.6 | 2.92 | 9,974.14 | 11,416.00 | -11.0% | -12.6% | 328,694 | 290,216 |
| 1,579,516,467,629,270,577 | 2.67 | 2.97 | 9,785.28 | 9,743.09 | -10.2% | 0.4% | 279,803 | 284,453 |
| -7,995,682,717,897,123,039 | 2.67 | 2.92 | 15,060.60 | 12,147.39 | -8.4% | 24.0% | 4,799,866 | 5,106,336 |
| 6,974,535,101,123,239,131 | 2.87 | 2.65 | 9,198.88 | 7,837.62 | 8.1% | 17.4% | 547,471 | 583,345 |
| -1,016,849,053,752,795,150 | 2.81 | 3.05 | 9,662.00 | 10,758.76 | -7.7% | -10.2% | 387,166 | 397,259 |
| -7,572,382,112,705,938,029 | 2.16 | 2.02 | 6,554.15 | 5,772.49 | 6.9% | 13.5% | 411,394 | 424,312 |
| -4,445,518,905,666,343,797 | 2.16 | 2.03 | 18,337.46 | 14,297.72 | 6.3% | 28.3% | 183,602 | 185,851 |
| 7,616,836,552,481,822,175 | 2.4 | 2.26 | 9,807.31 | 8,258.19 | 6.1% | 18.8% | 4,041,670 | 4,222,895 |
| 1,017,413,876,722,652,424 | 2.26 | 2.13 | 8,718.79 | 7,315.35 | 6.0% | 19.2% | 3,717,730 | 3,855,691 |
| 5,177,932,399,303,345,046 | 1.94 | 1.83 | 6,733.20 | 5,857.74 | 5.7% | 14.9% | 1,500,206 | 1,664,157 |
| -4,138,824,164,451,705,107 | 2.02 | 2.14 | 6,990.75 | 10,889.59 | -5.6% | -35.8% | 282,325 | 337,700 |
| -3,711,121,367,896,011,833 | 2.42 | 2.31 | 7,533.38 | 6,730.67 | 5.0% | 11.9% | 2,580,155 | 2,831,652 |
| -434,992,428,366,718,724 | 2.48 | 2.36 | 6,514.30 | 5,780.04 | 5.0% | 12.7% | 1,197,419 | 1,310,748 |
| -4,061,814,287,107,819,804 | 2.27 | 2.38 | 3,648.81 | 4,269.90 | -4.8% | -14.5% | 133,500 | 179,439 |
| -7,942,674,608,514,495,282 | 2.12 | 2.22 | 8,364.63 | 7,367.15 | -4.3% | 13.5% | 1,046,664 | 1,053,365 |
| -4,564,247,599,614,740,658 | 2.06 | 2.15 | 6,093.83 | 6,868.09 | -4.2% | -11.3% | 506,348 | 520,020 |
| -1,205,712,746,611,102,743 | 3.18 | 3.32 | 7,752.59 | 10,407.50 | -4.0% | -25.5% | 483,298 | 538,619 |
| 5,781,103,079,387,890,636 | 1.73 | 1.66 | 4,310.34 | 3,582.48 | 3.7% | 20.3% | 1,214,529 | 1,203,453 |
| -8,403,435,045,225,894,954 | 1.91 | 1.98 | 5,488.34 | 6,842.79 | -3.6% | -19.8% | 392,050 | 420,092 |
| 1,222,051,438,589,625,017 | 2.48 | 2.57 | 9,869.67 | 12,541.82 | -3.6% | -21.3% | 786,186 | 991,273 |
| 515,753,131,988,643,145 | 1.96 | 1.9 | 6,256.35 | 5,421.85 | 3.2% | 15.4% | 1,395,886 | 1,251,379 |
| -3,111,440,664,317,846,556 | 1.85 | 1.8 | 7,846.13 | 7,072.99 | 2.9% | 10.9% | 225,701 | 240,106 |
| -7,973,680,817,747,944,938 | 1.84 | 1.88 | 6,251.93 | 5,512.39 | -2.4% | 13.4% | 993,550 | 1,002,368 |
| -7,365,202,427,208,089,985 | 2.24 | 2.19 | 8,762.12 | 7,954.84 | 2.3% | 10.1% | 627,011 | 638,479 |
| 707,343,854,139,029,255 | 1.88 | 1.92 | 6,549.29 | 5,837.89 | -2.2% | 12.2% | 1,026,084 | 1,029,075 |
| 5,645,818,248,035,806,861 | 1.92 | 1.88 | 7,826.61 | 9,226.36 | 1.8% | -15.2% | 703,219 | 770,350 |
| -4,630,321,108,541,466,571 | 1.77 | 1.74 | 7,225.40 | 8,393.66 | 1.6% | -13.9% | 809,596 | 892,136 |
| 7,900,428,585,805,602,831 | 1.76 | 1.73 | 5,505.38 | 4,122.99 | 1.4% | 33.5% | 181,985 | 210,107 |
| 8,611,629,356,743,080,984 | 2.58 | 2.54 | 9,316.95 | 7,856.55 | 1.3% | 18.6% | 3,919,386 | 4,114,148 |
| -6,543,868,296,982,650,519 | 2.57 | 2.54 | 12,281.18 | 10,987.11 | 1.3% | 11.8% | 2,464,266 | 2,619,326 |
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_line | new_roid_count | old_roid_count | roid_count_change | roid_count_pct_change |
|---|---|---|---|---|
| MSK | 45,505,157 | 54,439,715 | -8,934,558 | -16.4% |
| Oncology | 8,590,032 | 7,497,029 | 1,093,003 | 14.6% |
| ENT | 11,334,770 | 13,233,544 | -1,898,774 | -14.3% |
| Dental | 370,136 | 425,799 | -55,663 | -13.1% |
| Ophthalmology | 12,089,164 | 13,802,176 | -1,713,012 | -12.4% |
| Gastrointestinal | 18,608,157 | 21,014,376 | -2,406,219 | -11.5% |
| Transplant | 65,016 | 72,833 | -7,817 | -10.7% |
| Reproductive | 7,688,347 | 8,595,436 | -907,089 | -10.6% |
| Urology | 8,651,530 | 9,671,884 | -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_type | new_roid_count | old_roid_count | roid_count_change | roid_count_pct_change |
|---|---|---|---|---|
| Laboratory | 3,535,461 | 2,158,493 | 1,376,968 | 63.8% |
| ASC | 15,194,451 | 25,049,884 | -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
| state | new_roid_count | old_roid_count | roid_count_change | roid_count_pct_change |
|---|---|---|---|---|
| SD | 1,379,892 | 1,787,289 | -407,397 | -22.8% |
| ND | 1,080,809 | 1,347,092 | -266,283 | -19.8% |
| MT | 1,643,642 | 2,009,110 | -365,468 | -18.2% |
| AK | 504,206 | 609,886 | -105,680 | -17.3% |
| VT | 423,941 | 508,507 | -84,566 | -16.6% |
| WY | 695,031 | 832,045 | -137,014 | -16.5% |
| DE | 705,421 | 825,496 | -120,075 | -14.5% |
| IA | 4,763,064 | 5,491,927 | -728,863 | -13.3% |
| UT | 1,763,309 | 2,028,198 | -264,889 | -13.1% |
| NE | 2,954,837 | 3,317,381 | -362,544 | -10.9% |
| KS | 4,748,811 | 5,291,078 | -542,267 | -10.2% |
| MN | 6,927,143 | 7,702,954 | -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_name | new_roid_count | old_roid_count | roid_count_change | roid_count_pct_change |
|---|---|---|---|---|
| Blue Cross Blue Shield of Maryland & DC (CareFirst) HMO | 662,036 | 179,939 | 482,097 | 267.9% |
| Regence Blue Cross Blue Shield OR PPO | 832,000 | 360,457 | 471,543 | 130.8% |
| Blue Cross Blue Shield of Montana Blue Preferred PPO | 290,118 | 410,080 | -119,962 | -29.3% |
| EmblemHealth GHI / Anthem CBP | 235,887 | 323,065 | -87,178 | -27.0% |
| Avera Health Plans Avera Health | 133,500 | 179,439 | -45,939 | -25.6% |
| Sanford Health Plan PPO | 786,186 | 991,273 | -205,087 | -20.7% |
| Anthem NH HMO | 335,159 | 286,309 | 48,850 | 17.1% |
| MetroPlus Health Gold | 700,725 | 838,418 | -137,693 | -16.4% |
| Wellmark Blue Cross Blue Shield SD PPO | 282,325 | 337,700 | -55,375 | -16.4% |
| Cigna MO HMO | 379,525 | 451,022 | -71,497 | -15.9% |
| WPS PPO | 1,013,127 | 1,196,679 | -183,552 | -15.3% |
| Premera Blue Cross Alaska Heritage Network | 175,626 | 207,106 | -31,480 | -15.2% |
| Anthem NH OPEN ACCESS | 364,781 | 317,081 | 47,700 | 15.0% |
| Kaiser Permanente Kaiser Health Plan (HI) | 181,985 | 210,107 | -28,122 | -13.4% |
| Anthem ME HMO | 328,694 | 290,216 | 38,478 | 13.3% |
| Moda Health Connexus | 515,344 | 458,754 | 56,590 | 12.3% |
| Blue Cross Blue Shield of Tennessee PPO | 1,395,886 | 1,251,379 | 144,507 | 11.5% |
| Anthem ME Blue Choice PPO | 342,537 | 307,821 | 34,716 | 11.3% |
| Blue Cross Blue Shield of North Dakota PPO | 321,165 | 361,451 | -40,286 | -11.1% |
| Cigna VA HMO | 496,551 | 556,617 | -60,066 | -10.8% |
| UnitedHealthcare HMO | 55,175,818 | 61,644,316 | -6,468,498 | -10.5% |
| Anthem GA OPEN ACCESS | 1,738,523 | 1,575,920 | 162,603 | 10.3% |
| Kaiser Permanente Kaiser Health Plan (CO) | 483,298 | 538,619 | -55,321 | -10.3% |
| Blue Cross Blue Shield of Vermont PPO | 87,457 | 97,319 | -9,862 | -10.1% |
| UnitedHealthcare Choice Plus | 57,213,715 | 63,623,745 | -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_id | payer_name | network_name | canonical_rate_source | n_old | n_new |
|---|---|---|---|---|---|
| 791 | MotivHealth Insurance Company | MotivNet | payer | 32,594 | 0 |
| 317 | Tufts Health Plan | HMO | payer | 1,092 | 0 |
| 317 | Tufts Health Plan | PPO MA | payer | 258 | 0 |
| 791 | MotivHealth Insurance Company | MotivNet | imputation | 101 | 0 |
| 397 | Blue Cross Blue Shield of Rhode Island | PPO | imputation | 139 | 50 |
| 458 | Blue Cross Blue Shield of North Dakota | PPO | imputation | 3,119 | 89 |
| 628 | Premera Blue Cross | Alaska Heritage Network | imputation | 556 | 534 |
| 42 | Anthem | NH HMO | imputation | 570 | 586 |
| 53 | Blue Cross Blue Shield of Oklahoma | Blue Preferred PPO | imputation | 668 | 625 |
| 462 | Blue Cross Blue Shield of Vermont | PPO | imputation | 4,010 | 1,048 |
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_type | health_system_name | new_roid_count | old_roid_count | roid_count_change | roid_count_pct_change |
|---|---|---|---|---|---|
| Hospital | PAM Health | 127,423 | 228,674 | -101,251 | -44.3% |
| Hospital | CHRISTUS Health Shreveport - Bossier Health System | 138,141 | 96,559 | 41,582 | 43.1% |
| ASC | Baylor Scott & White Health | 74,069 | 119,333 | -45,264 | -37.9% |
| ASC | AMSURG | 362,557 | 583,004 | -220,447 | -37.8% |
| Hospital | TMC Health | 127,509 | 93,338 | 34,171 | 36.6% |
| ASC | Texas Health Resources | 66,699 | 104,889 | -38,190 | -36.4% |
| ASC | Surgery Partners | 439,584 | 679,266 | -239,682 | -35.3% |
| Hospital | Avera Health | 643,775 | 969,890 | -326,115 | -33.6% |
| ASC | Virtua Health | 94,971 | 141,747 | -46,776 | -33.0% |
| ASC | United Surgical Partners International | 2,027,638 | 3,004,028 | -976,390 | -32.5% |
| ASC | SCA Health | 817,702 | 1,190,790 | -373,088 | -31.3% |
| ASC | Ambulatory Surgical Centers of America | 71,434 | 102,754 | -31,320 | -30.5% |
| Hospital | Ernest Health | 101,950 | 146,508 | -44,558 | -30.4% |
| ASC | Inova | 82,288 | 117,800 | -35,512 | -30.1% |
| ASC | Memorial Hermann Health System | 88,405 | 126,512 | -38,107 | -30.1% |
| Hospital | UnityPoint Health Fort Dodge | 108,126 | 153,281 | -45,155 | -29.5% |
| Hospital | OakBend Medical Center Health System | 72,940 | 103,041 | -30,101 | -29.2% |
| Hospital | CHI St Alexius Health Bismarck | 131,340 | 184,957 | -53,617 | -29.0% |
| Hospital | Logan Health | 94,784 | 133,093 | -38,309 | -28.8% |
| Physician Group | Franciscan Missionaries of Our Lady Health System | 98,566 | 138,134 | -39,568 | -28.6% |
| Hospital | FirstHealth of the Carolinas | 100,777 | 140,080 | -39,303 | -28.1% |
| Physician Group | Albany MED Health System | 212,411 | 294,603 | -82,192 | -27.9% |
| Physician Group | Beth Israel Lahey Health | 119,960 | 166,294 | -46,334 | -27.9% |
| Hospital | Encompass Health Corporation | 820,725 | 1,116,644 | -295,919 | -26.5% |
| Physician Group | John Muir Health | 76,979 | 104,046 | -27,067 | -26.0% |
| Physician Group | BayCare Health System | 77,297 | 104,235 | -26,938 | -25.8% |
| ASC | Dignity Health | 118,103 | 159,183 | -41,080 | -25.8% |
| Physician Group | Aurora Health Care | 134,939 | 180,964 | -46,025 | -25.4% |
| Physician Group | Kaleida Health | 96,592 | 129,374 | -32,782 | -25.3% |
| Hospital | Billings Clinic Health System | 233,997 | 312,910 | -78,913 | -25.2% |
| Hospital | MercyOne | 651,406 | 869,378 | -217,972 | -25.1% |
| Hospital | Great Plains Health Alliance | 557,861 | 727,103 | -169,242 | -23.3% |
| Hospital | Mayo Clinic | 165,754 | 134,588 | 31,166 | 23.2% |
| Hospital | CHI Saint Joseph Health | 236,230 | 192,136 | 44,094 | 22.9% |
| Physician Group | Aspirus Health | 237,511 | 307,561 | -70,050 | -22.8% |
| Hospital | HCA North Carolina Division | 180,535 | 233,119 | -52,584 | -22.6% |
| Physician Group | UMass Memorial Health Care | 97,318 | 123,643 | -26,325 | -21.3% |
| ASC | HCA Surgery Center Division | 679,028 | 860,938 | -181,910 | -21.1% |
| Hospital | Sanford Health | 715,011 | 898,740 | -183,729 | -20.4% |
| Physician Group | Sentara Health | 172,832 | 215,924 | -43,092 | -20.0% |
| Physician Group | Wellstar MCG Health | 82,530 | 102,852 | -20,322 | -19.8% |
| Physician Group | Covenant Health | 92,438 | 114,357 | -21,919 | -19.2% |
| Hospital | One Brooklyn Health System | 229,437 | 283,799 | -54,362 | -19.2% |
| Physician Group | Providence Health & Services - Oregon and Southwest Washington | 196,210 | 164,729 | 31,481 | 19.1% |
| Hospital | Northwest Texas Healthcare System | 101,458 | 125,174 | -23,716 | -18.9% |
| Hospital | CentraCare Health System | 254,864 | 313,673 | -58,809 | -18.7% |
| Hospital | Shannon Health | 157,948 | 133,300 | 24,648 | 18.5% |
| Physician Group | Duke LifePoint Healthcare | 102,239 | 124,731 | -22,492 | -18.0% |
| Physician Group | Salem Health | 104,141 | 88,410 | 15,731 | 17.8% |
| Hospital | HCA Continental Division - Wesley Healthcare | 93,184 | 113,255 | -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_score | new_roid_count | old_roid_count | roid_count_change | roid_count_pct_change |
|---|---|---|---|---|
| 3 | 181,296,149 | 83,808,134 | 97,488,015 | 116.3% |
| 2 | 42,035,969 | 22,264,856 | 19,771,113 | 88.8% |
| 4 | 127,692,004 | 268,722,492 | -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_type | canonical_rate_score | new_roid_count | old_roid_count | roid_count_change | roid_count_pct_change |
|---|---|---|---|---|---|
| ASC | 2 | 174,837 | 329,312 | -154,475 | -46.9% |
| ASC | 4 | 14,781,255 | 24,487,408 | -9,706,153 | -39.6% |
| Hospital | 4 | 108,442,836 | 128,476,272 | -20,033,436 | -15.6% |
| Hospital | 3 | 58,842,617 | 51,281,223 | 7,561,394 | 14.7% |
| Laboratory | 5 | 1,725,375 | 952,334 | 773,041 | 81.2% |
| Laboratory | 4 | 223,078 | 141,848 | 81,230 | 57.3% |
| Laboratory | 3 | 1,102,616 | 733,853 | 368,763 | 50.3% |
| Laboratory | 2 | 484,392 | 330,458 | 153,934 | 46.6% |
| Physician Group | 3 | 121,112,197 | 31,559,540 | 89,552,657 | 283.8% |
| Physician Group | 2 | 27,164,668 | 7,902,222 | 19,262,446 | 243.8% |
| Physician Group | 4 | 1,265,107 | 112,588,567 | -111,323,460 | -98.9% |
| Physician Group | 5 | 929,642 | 546,220 | 383,422 | 70.2% |
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_class | new_roid_count | old_roid_count | roid_count_change | roid_count_pct_change |
|---|---|---|---|---|
| Impute | 62,027,994 | 79,160,748 | -17,132,754 | -21.6% |
| Transform | 24,960,532 | 30,956,297 | -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_source | new_roid_count | old_roid_count | roid_count_change | roid_count_pct_change |
|---|---|---|---|---|
| imputation | 62,027,994 | 79,160,748 | -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_methodology | new_roid_count | old_roid_count | roid_count_change | roid_count_pct_change |
|---|---|---|---|---|
| Per Diem | 4,148,724 | 3,431,956 | 716,768 | 20.9% |
| Case Rate | 85,591,208 | 104,246,229 | -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_method | new_roid_count | old_roid_count | roid_count_change | roid_count_pct_change |
|---|---|---|---|---|
| Crosswalked From CSTM-ALL to APR-DRG | 726,342 | 939,160 | -212,818 | -22.7% |
| Crosswalked From NDC to HCPCS | 841,012 | 1,044,354 | -203,342 | -19.5% |
| Crosswalked From CSTM-ALL to MS-DRG | 611,444 | 744,246 | -132,802 | -17.8% |
| Crosswalked From RC-FAMILY to MS-DRG | 752,632 | 660,900 | 91,732 | 13.9% |
| Crosswalked From RC-FAMILY to APR-DRG | 964,179 | 859,290 | 104,889 | 12.2% |
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_type | new_roid_count | old_roid_count | roid_count_change | roid_count_pct_change |
|---|---|---|---|---|
| mrf_gross_charge_cbsa_median | 18,310,739 | 32,430,284 | -14,119,545 | -43.5% |
| komodo_gross_charge_state_median | 10,893,878 | 9,514,742 | 1,379,136 | 14.5% |
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