Cost Category Scope of Services

The MIPS Cost category accounts for 30% of your total score and is calculated automatically by CMS using your Medicare claims. While many believe it's unchangeable, we help you take a smarter approach by analyzing your data and identifying operational leverage points.

What We Offer:

• Annual CMS Cost Feedback Review to interpret performance across episode-based measures, TPCC, and MSPB.
  

• Attribution Analysis to explain how patient assignments are made and how your organization can influence this process.
  

• Operational Insights to identify patterns driving excess costs — without requiring changes to your care model.
  

• High-Spend Episode & Patient Flagging so you can see where spending exceeds benchmarks and take informed action.
  

• CMS Methodology Translation to demystify scoring mechanics and support fairer, more informed performance tracking.
  

• Strategic Recommendations to improve your cost profile year-over-year through operational fine-tuning.

• Annual Regulatory Updates with our policy experts to distill the complexity of new CMS rules, benchmarks, and scoring changes in plain language