CareSet: Medicare Data Analysis & Patient Care Insights

No projections with census-level coverage.
No blocked brands, accounts or payors.
Mapping Medicare claims data since 2011.

CareSet analyzes Medicare claims to uncover provider influence, unblock gaps in data, and map patient journeys.

“When weeks, even days matter with our Line-of-Therapy(LoT), accuracy and timeliness matters. Until CareSet, we didn’t realize we had gaps in data, making physician targeting much more difficult.”

- Senior Director of Analytics, Orphan Drug Manufacturer.”

Competitive PLD vendors typically access only 70% of Medicare Part D and just 40% of Parts A and B, leading to notable gaps in treatment analytics.

CareSet Analyzes Prescribers Writing Blocked Brands and Uncovers the True Treatment Journey for Patients.

Each data point is a potential insight into a patient's condition, a doctor's decision, or a policy's impact. Our strength lies in deciphering complex Medicare A, B, and D claims, including those blocked or redacted brands, accounts, and payor data points, uncovering insights hidden to most.

Unlock Medicare Insights

Find More Doctors and Accounts

"CareSet identified 15% more targets, and with the increased coverage, we found 250% more patients indicated for our treatment."

- Analytics Director, Buy and Bill Manufacturer

Our Data Sources

By diving into $1.100+ trillion in annual claims, we spot key spending trends and resource needs. Our constantly updated 14-year claims data means we're always on top of market changes. Plus, we blend in over 100 external data sources to give a full, clear picture of the healthcare market. Our healthcare analytics solutions give life sciences companies an edge.

62+ M

Patients

6M

HCOs

$1.1+ T

in annual
Medicare claims

14+ Years

Medicare claims data (on a monthly basis)

100+

External Metadata (Public & Private sources)

What we do

Monthly census-level insights

NPI-labeled provider network

No blocked brands, accounts or payors.

Understand treatments, providers, and utilization

Map Physician Affiliations

See Buy & Bill Administration

Our monthly Medicare updates improve provider engagement with novel insights into drug utilization and answer critical business questions, including:

Which diseases, defined by ICD, do providers diagnose and treat?
Using NDC and HCPCS codes to define interventions, how do providers move patients through their journey from diagnosis through lines-of-therapy?
How do patients navigate from diagnosis to treatment to cure, across Medicare A, B, and D benefits?
What treatments are Medicare Part D Plans approving and how much do they pay?

Who prescribes or infuses treatments in a brand's therapeutic area?
Which healthcare settings are most strongly associated with codes of interest?
What is the association between HCPCS, ICD, DRGs, and NCDs in a therapeutic area?

Find More Doctors and Accounts

“CareSet identifies 15% more targets and 250% more patients than [leading claims vendor].”

-Marketing Analytics DirectorTop 5 Life Science Company

Common NPIs

CareSet delivered 750 new HCP targets

HCPs identified in commercial claimns

“When weeks, even days matter with our Line-of-Therapy (LoT), accuracy and timeliness matters. Until CareSet, we didn’t realize we had gaps in data, making physician targeting much more difficult.”

- Senior Director of Analytics, Orphan Drug Manufacturer.”

Medicare Experts & Monthly Insignts

Big Data Record

62+ M

Beneficiaries (aggregated by codes)

6 M

Provideers (HCPs and HCos)

$900 +

Billion Dollar Claims per year

14+ Years

Of claims data(up to previous month)

> 100

External Metadata (Public & Private sources)

Monthly census-level insights
NPI-labeled provider network
No blackout markets or accounts
Understand treatments, providers, and utilizations
Map Physician Affiliations
See Buy & Bill Administrations

Defining Medicare

Diverse patient populations, dynamic regulatory landscapes, and complex healthcare systems are making it harder than ever to get innovative pharmaceutical products into the hands of patients who need them.

Our Medicare data solutions overcome common market research challenges, support data transparency, and enable our clients to gain a comprehensive view of patient needs and how best to meet them.

With CareSet, our clients have unparalleled up-to-date knowledge of the use of pharmaceutical products within Medicare, including which ones are used, where, when, and by which populations. This information guides strategy for the entire lifecycle of pharmaceuticals, including customer engagement, pharmacy and market access, launch strategy, performance management and brand strategy.

Unlock Payor Insights

Innovative Medicare Insights Revolutionize Pharma Strategy

CareSet implements innovative data solutions to overcome obstacles to understanding the needs and uses of specific drug therapies.

We have full access to Medicare, Parts A, B, and D data, so our solutions do not rely on inevitably flawed projections. Instead, they are data-driven and effective.
We aggregate data at the physicians, pharmacy, and organization level to get a comprehensive understanding of the impact of therapeutic treatments.

Part A
(Impatient)

Medical Benefits (CMS-1450)
Hospital Site and CCN Names
Rendering, Attending, Surgery Physicians
DRG, ICD-Procedure, Revenue Center, NDC, ICD

Part A
(Pharmacy)

Prescription Benefits
Prescriber NPI
Pharmacy Identifier
Pharmacy Chain (via NCPDP DataQ)

Part B
(Institutional Outpatient)

Medical Benefits (CMS-1450)
Hospital Site and CCN Names
Rendering, Referring, Attending, and Surgical NPIs
HCPCS, Modifiers, Revenue Center, NDC, ICD

Part B
(Career Outpatient)

Medical Benefits (CMS-1500)
Clinic/Practice/Free Standing Organization Names
Performing, and Referring NPIs
HCPCS, Modifiers, ICD Codes

Data Leadership

At CareSet, we are passionate advocates for open and accessible healthcare data, believing that it is crucial for improving patient outcomes and advancing the industry. As data leaders, we harness the potential of Medicare claims, combining medical innovations with external data assets to ensure that therapeutic treatments reach those who need them most effectively.

Our expertise lies in delving into Medicare data to extract meaningful insights. By unlocking this data, we gain a comprehensive understanding of patient journeys throughout the continuum of care. This valuable information is made accessible to journalists, researchers, payers, hospitals, and pharmaceutical companies, empowering evidence-based decision-making and driving progress in healthcare.

Our commitment to quality is unwavering, as we deliver essential insights to our clients while maintaining the utmost respect for patient privacy and protection. Over time, our approach has evolved to provide more complex insights and conduct in-depth analyses. For example, we closely monitor monthly shifts in patient flows and changes in prescribing patterns among providers, enabling better decision-making and improved patient care.

At CareSet, we are proud to lead in the realm of healthcare data, making a positive impact on patient care and the future of the industry.

CareSet's Medicare Expertise and Insights Tackles Critical Business Questions:

Who is in each specialty pharmacy’s network?

What is the diagnosis to treatment path?

Who’s treating what?

Who drives adherence?

How do providers impact patient journeys?

How does the IRA affect Medicare Part D Coverages and Costs?

Our commitment to quality is unwavering, as we deliver essential the highest quality of healthcare analytics and insights to our clients while maintaining the utmost respect for patient privacy and protection. Over time, our approach has evolved to provide more complex healthcare insights and conduct in-depth analyses. For example, we closely monitor monthly shifts in patient flows and changes in prescribing patterns among providers, enabling better decision-making and improved patient care.

At CareSet, we are proud to lead in the realm of healthcare data analytics, positively impacting patient care and the industry's future.

Contact Us