Leaders in Healthcare Transparency.
Data. Journalism. Advocacy. Research.

At CareSet, we are passionate advocates for open and accessible healthcare data. We believe data transparency is crucial for improving outcomes and advancing the industry.

We also believe that information is most powerful when combines with expertise. We delve into Medicare data to create a comprehensive understanding of patient journeys throughout the continuum of care. This valuable information is made accessible to journalists, researchers, payers, hospitals, and life sciences to empower evidence-based decisions and research.

As Data Leaders, we

Enhance therapeutic treatment accessibility

Offer expert analysis to aid data understanding

Promote open access to healthcare data for journalists

Advocate for patient-centered government policies & high-quality open data

DocGraph Data: Medicare Referral Transparency

Our most popular Public Use File (PUF) shows Medicare providers in the United States working together. It provides the most detailed and current picture of the patient-sharing relationships in the U.S. healthcare system that is publicly available.

The goal of our implied-referral data is to:

  • Reflect referrals and collaborations between healthcare providers by showing the number of patients they share in common.
  • Reveal the directionality of the referral relationships.
The DocGraph Hop Teaming dataset contains the following data fields:
From_NPI
The provider first in sequence, coded by NPI
To_NPI
The provider second in sequence, coded by NPI.
Patient_Count
The total number of patients shared between the two providers over the entire time period (the time period is typically one year).
Transaction_count
The count of times a patient switched between the two providers, in the from-to-direction.
Average_day_unit
The average number of days it took for a “Hop” to occur. This is the time it took, in days, for a patient to switch to the second provider after having seen the first provider.
STD_day_wait
The standard deviation of days it took for a Hop to occur.
NPI
The National Provider Identifier is a unique identifier assigned to a person or institution that bills for services in the U.S. CMS releases information for each. NPI on their NPPES data download site lists the provider first in sequence, coded by NPI

Journalism

Collaborate

with ProPublica,The Wall Street Journal, and Reuters

Team

with academics and researchers

Support

top 20 manufacturers with monthly data
We provide data and analysis to journalists to support their investigations into Medicare. We’ve helped uncover fraud, waste, abuse, and the impact of COVID-19.

Research using our data

Our PUFs have been used by researchers who want to understand the structure of the healthcare system from a national level. Many in our research community examine how provider networks are related to insurance plans, SDOH, data interoperability, cost and quality outcomes, as well as the impact of COVID-19 on provider networks.

Health Services Research

  • Graves, John A., et al. “Physician-patient sharing relationships within insurance plan networks. ”Health services research (2023).
  • Lou, Qian, Nicholas Chong, and Candice Chen. “Independent freestanding emergency departments and implications for the rural emergency physician workforce in Texas. ”Health Services Research 55.6 (2020): 1013-1020.

BMJ Open

  • Linde, Sebastian, and Leonard E. Egede. “Retrospective observational study of the robustness of provider network structures to the systematic shock of COVID-19; a county level analysis of COVID-19 outcomes. ”BMJ open 12.5 (2022: e059420.

Medical Care

  • Everson, Jordan, and Julia Adler-Milstein. “Electronic Connectivity Among Us Hospitals Treating Shared Patients,” Medical Care 60.12 (2022): 880-887

Urban Institue

  • Blavin, Fredric, et al. “Opportunities to Improve Data Interoperability and Integration to Support Value-Based Care.” (2022).

PubMed

PubMed Central (PMC)

  • Electronic Connectivity Among Us Hospitals Treating Shared Patient

Advocacy

CareSet advocates for the government to release and support high quality, and open healthcare data. We frequently submit comments on proposed rules to outline our support for data transparency and patient privacy. We lead a VRDC Users Group to help other researchers accessing Medicare and Medicaid data to voice their advocacy priorities to the government.

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