Procedures

What is it?

Ribbon's Procedures indices provide three data elements to customers, all at the procedure level -

• Relative experience index - how experienced is a given provider in performing a given procedure, relative to their peers?
• Relative cost index - how expensive is a given provider in performing a given procedure, relative to peers in their area?
• Regional cost estimate - how much does a procedure typically cost in a given geography?

Information on procedures over 1000 commonly delivered procedures, including the 500 shoppable procedures identified by CMS.

Why is it useful?

Members and patients are hungry for information about how much care costs, and where to find high-value options. Ribbon's Procedures data can be used to enable a few different workflows:

• Care Navigation: Search for providers by the services they offer. This provides a more granular search experience than using specialties - for example, you can specifically search for providers that perform colonoscopies rather than searching for the broader 'Gastroenterology' specialty.
• Procedure Cost/Experience: See how expensive/effective a provider is at performing a specific procedure relative to their peers (on a scale of 1-10).
• Procedure Cost Estimate: Find the average cost of performing a procedure within a given region.

Methodology

Ribbon groups semantically similar CPT codes into single procedures based on input from clinical advisors and a quantitative analysis of billing patterns. Around 3,450 CPT Codes are represented in the index across procedures. For relative indexes, we use a statistical approach to determine relative behavior compared to a mean and map provider-level scores to a scale from 1 to 10.