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.
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.
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.
For any given doctor compared to their peers, we answer two questions:
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.
Modus rated doctors are those who have consistently delivered better care quality at lower cost.
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.
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.
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.
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:
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.