Medicare Claims Data Analysis: Primary Care Access
Using longitudinal Traditional Medicare claims to measure primary care access and value-based care adoption.
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Case Studies
FastHSR Claims Analytics Case Studies
Review examples of Medicare and Medicaid claims analyses. FastHSR delivers rapid healthcare market intelligence built on complete medical and prescription utilization patterns for more than 150 million Medicare and Medicaid beneficiaries. Hundreds of billions of records offer a holistic, longitudinal view of the beneficiary population. Our analyses draw on 100% traditional Medicare claims (Parts A and B), Medicare Advantage encounter data, the beneficiary enrollment file, Medicare Part D, and Medicaid claims. We supplement claims with beneficiary-level HEDIS files, CAHPS survey data, NCPDP pharmacy data, and a range of proprietary crosswalks.
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Medicaid Reimbursement Analysis: Pediatric Surgery DRGs
Mapping pediatric surgery procedures to DRGs and quantifying historical Medicaid allowed and paid amounts.
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Using Medicare claims and MA encounter files to create PCP-level cost, utilization, risk, proxy MLR, and NCQA quality measures.
Read case studyHEDIS Denominator and Numerator Analysis
Using individual-level HEDIS files to calculate MA contract-level denominators and numerators for Star Ratings strategy.
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Using Medicare claims and Part D data to measure diabetes, hypertension, and cholesterol adherence at population scale.
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Measuring colorectal cancer screening rates, provider availability, and cancer treatment patterns with Medicare claims.
Read case studyCMS Medicare Provider and DME Data Refresh
Recreating CMS public-data methods from Medicare claims to deliver recent-year, rolling 12-month, and quarterly provider-service files.
Read case studyPart D Pharmacy Market and Reimbursement Analysis
Analyzing oncology drug pharmacy channels, PBMs, brand/generic versions, formulations, and reimbursement percentiles.
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Evaluating a primary care group's performance using Medicare claims, MA encounter data, ACO benchmarks, and peer comparisons.
Read case studyHealth System ACO Competitor Performance Analysis
Using Medicare claims to compare a health-system-affiliated ACO with a local peer through attribution, risk, cost, and NPI-level performance measures.
Read case studyMedicare Advantage Encounter Cost Estimation
Estimating MA healthcare costs by combining encounter utilization, Traditional Medicare FFS claims, published fee schedules, and standardized pricing logic.
Read case studyACO Mental Health Population Size Analysis
Using Medicare claims to estimate mental health patient population size for each ACO with attribution, cohort definitions, and suppression-ready outputs.
Read case studyRetinal Imaging and EED Provider Targeting
Identifying PCPs and value-based care organizations with diabetic eye exam screening gaps using EED data, claims, and attribution logic.
Read case studyUnderdiagnosed Condition Care Coordination Analysis
Using Medicare claims to map comorbidities, provider networks, specialty handoffs, continuity, and patient journeys for a poorly coordinated condition.
Read case studyBehavioral Health Medicare Patient Profile and Impact Analysis
Profiling Medicare behavioral health patients, therapy cadence, billing patterns, referral pathways, and pre/post utilization using claims.
Read case studyDigital Social Work Benefit Enrollment Impact Analysis
Evaluating benefit enrollment impact with MA encounter data, enrollment files, Part D events, matching, and difference-in-differences.
Read case studyMedicare Part D Prescribers by Provider, Drug, Pharmacy, and Plan
Aggregating Part D prescriptions by provider, drug, pharmacy, and plan ID with costs, beneficiary counts, utilization, and flexible grouping levels.
Read case studyMedicaid Service TAM Analysis by CPT, HCPCS, Modifier, and Revenue Code
Using five years of Medicaid/CHIP claims to estimate service TAM by code, state, and year with patient months, claims, service quantity, and unique patients.
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