Frequently Asked Questions

Look for commonly asked questions. If you can’t find your answer, don’t hesitate to reach out to our team
What is Modus?

Modus is a privately held healthcare company incorporated in Michigan, USA, taking a completely fresh approach to healthcare care. Our sophisticated Clinical intelligence analytics model rates doctors  to ensure patients are guided only to those who have shown consistent better outcomes.

Why should your organization invest in musculoskeletal care?

Musculoskeletal (MSK) care accounts for the highest expenditure in terms of healthcare for employers: Group Health: average of $150 per patient per month (30% of total cost of care) and Workers Compensations: average of $70 per patient per month (90% of total cost of care). There are over 150 potential MSK diagnoses that affect the MSK system. Data suggests that close to 50% of Americans live with a MSK condition - a burden comparable to the combined prevalence of both respiratory and cardiovascular disease - costing the United States an estimated 61.2 billion dollars per year.

What is Modus Clinical Intelligence?

Our Clinical Intelligence Analytics identifies and rates musculoskeletal doctors based on quality metrics and their tendency to escalate a normal claim into catastrophic. Modus optimizes existing networks to ensure employees or members are guided only to those who have consistently delivered better care quality at lower cost.

How does Modus rate doctors?

For any given doctor compared to their peers, we answer two questions:

  • How aggressive, conservative, and expensive?
  • Surgeries / Procedures on new patients
  • Spine fusion / other surgeries
  • Scopes / other surgeries
  • Opioids Rx  and Cost/Patient
  • Are his/her patients better or worse off after surgery?
  • 1 Year Mortality rate
  • Post Op average days (Hospital, Long term Care, Skilled Nursing Facility)
  • Failed surgery (% surgeries that are repeated on the same body part within 3 years)

What specialities are included in the Modus Clinical Intelligence?

Neurosurgery,  Orthopedic surgery (Spine, Hand, Foot& Ankle), Interventional Pain Management, Physical Medicine and Rehabilitation, Sports Medicine, Pain Management, and Podiatry. For each category, we have defined a tailored set of measures to reflect the differences in quality of care compared to same specialty peers.

Who are Modus rated doctors?

Modus rated doctors are those who have consistently delivered better care quality at lower cost.

What is the process to implement Modus in my organization?
  1. Target setting

We work collaboratively with you to understand your goals and priorities. With your claims data, we perform an advanced  analysis to set clear KPI’s and achievable targets aligned with your priorities.

  1. Modeling of your data

We categorize your existing providers into two categories: the recommended and the undesirable doctors.

Based on the agreed targets, we decide how restrictive we want the categories to be.

  1. Integration

We finalize the workflow procedures that enable your team to access Modus and start deploying your preferred access method. We work with your team to ensure the onboarding is smooth and effective.

How does Modus integrate within clients workflow?

We then deliver our Clinical Intelligence  directly to your team at the right moment of the user flow using one of the different options we have available:

  1. API-integrations: For teams that currently use and like specific claims management or patient navigation software, we can directly integrate with those softwares and send information in real time using APIs.
  2. Web-based portal: Our sophisticated web-based portal allows teams to search for specific locations and care specialities to produce a list of top recommended providers.
How accurate is Modus data?

We are the only solution for doctors' ratings on quality and cost using medicare data, evaluating a doctor's performance based on objective and meaningful outcome metrics.  Average analysis is 5400 billing codes per doctor. We use sophisticated and patented machine learning technology that leverages publically available and verifiable Medicare actual providers' claim data for 61 Million annual beneficiaries claims.