CCGroup Receives Access to National CMS Medicare Claims to Improve Physician and Hospital Efficiency of Care

SAN MATEO, Calif.--()--CCGroup, the market innovator and leader in reliably measuring physician efficiency, is pleased to announce that the Centers for Medicare & Medicaid Services (CMS) approved our Innovator project to access all Medicare fee-for-service (FFS) claims through the CMS Virtual Research Data Center (VRDC). With this distinction, CCGroup gains access to all acute care, post-acute care, physician visits, physician procedures, and pharmacy services for more than 38 million individuals each year. This includes all 50 states and the District of Columbia.

“Our study objectives are to nationally examine physicians’ and hospitals’ overall practice efficiency and medical condition practice efficiency,” stated Dr. Douglas G. Cave, President of CCGroup. Access to the Medicare FFS beneficiary claims will only add to CCGroup’s extensive experience and research with commercial, Medicaid, and Medicare Advantage populations. He continued, “We will further determine the specific healthcare services most responsible for efficient and inefficient primary care physician (PCP), specialist, and hospital practice pattern differences.”

Yuri Alexandrian, COO/CIO of CCGroup asserted, “CCGroup will share overall efficiency as well as medical condition-level efficiency results with health plans, health systems, clinically integrated networks (CINs), accountable care organizations (ACOs), and employers. Our goal is to help these organizations improve the efficiency of their current provider network offerings and composition.”

CCGroup has invested significant time and effort to determine and develop the most appropriate methods to obtain reliable and stable physician efficiency scores. “This effort began over 15 years ago with a CCGroup approved CMS study (utilizing complete CMS Medicare FFS claims) entitled Measuring Physician Efficiency by Specialty Type and Geographic Locations,” Dr. Cave said.

CCGroup has obtained numerous patents that protect our novel approach to analyzing physician efficiency using medical condition episodes-of-care, using a predefined set of medical conditions for a specialty type, and weighting these medical condition episodes-of-care together to calculate an overall physician efficiency score. No other competitor to CCGroup is allowed to offer our analytics, methods, statistics, and system – unless they have a license from CCGroup to do so.

CCGroup will apply these innovative efficiency analytics and statistics to the CMS Medicare FFS claims. “We will accurately and reliably measure the efficiency of over 70% of practicing physicians nationwide,” stated Mr. Alexandrian.

About Cave Consulting Group, Inc. (CCGroup)

Cave Consulting Group, Inc. is a software and consulting firm located in San Mateo, California. The company is focused on improving the efficiency (cost-of-care) and effectiveness (quality-of-care) of the healthcare delivery system. Senior management of CCGroup has assessed the performance of physicians and hospitals for over 28 years for health plans, HMOs, physician groups, health systems, CINs, ACOs, TPAs, and employers.


Mr. Yuri Alexandrian, CCGroup

Release Summary

CCGroup is pleased to announce that CMS approved our access to all Medicare fee-for-service claims through the VRDC.


Mr. Yuri Alexandrian, CCGroup