Medicare Program Integrity Analytics Dashboard

Home Health & Hospice Services: Composite Risk Score Analytics

$31.70B
Medicare FFS Improper Payments (7.66%)
12,112
Providers Analyzed
12
High Risk Providers Identified (0.1%)
469,402
Quality Measures Processed
Model Performance Metrics
91.7%
Precision
99.9%
Specificity
0.917
F1 Score
0.94
AUC ROC
4.3 min
Processing
Geographic Risk Distribution
State Providers High Risk Risk %
Texas 1,867 5 0.27%
Florida 1,089 2 0.18%
Massachusetts 294 2 0.68%
California 2,914 2 0.07%
Ohio 815 1 0.12%
Texas
5 high risk
Florida
2 high risk
Mass.
2 high risk
California
2 high risk
Ohio
1 high risk
Composite Risk Score Weights
S
Statistical Analysis
40%
M
Machine Learning
30%
Q
Quality Indicators
30%
E
Ensemble Agreement
87%
Risk Stratification Results
Critical
4
95 to 100 score
High
1
90 to 94 score
Medium
7
75 to 89 score
Low
12,100
0 to 74 score
25%
OIG Concordance
91.2%
Cross Validation
2,000
Bootstrap Iterations
12
High Risk Identified
Data Sources: CMS Home Health Compare (12,112 providers, 96 variables) | HHCAHPS Surveys (38.4% response rate) | Hospice Compare (7,007 providers, 469,402 records) | OIG LEIE Database | Medicare Geographic Variation (3,142 counties) | CMS Program Statistics
Technical Specifications: Processing Time: 4.3 minutes | Memory Usage: 1.2GB | Providers Analyzed: 12,112 | Federal Datasets: 6 | Isolation Forest: 300 estimators
Note: This system identifies statistical anomalies for further investigation, not confirmed improper payments.