Medicare
Who they are
Medicare is a government payer with a footprint nationwide as the federal benchmark every commercial contract is measured against. Medicare operates under parent company Centers for Medicare and Medicaid Services. For the providers who contract with it, the rates Medicare pays on high-volume procedures move the margin on every case.
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What DataLily Insights shows
DataLily Insights turns that footprint into answers. Rose, the AI analyst, reads more than 100 billion data points across over 10 million providers and explains in plain language how Medicare reimburses a given code in a given market. You can see where Medicare pays richer or leaner, how its allowed amounts compare to peer payers, and whether your contract is keeping pace.
What to watch
Because Medicare anchors what every other payer is measured against, reading it precisely matters. DataLily Insights puts Medicare side by side with commercial rates for the same code and market, so you can see exactly how far your commercial contracts sit above or below the public benchmark.
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A 15-minute walkthrough of Medicare the way it pays.
What Insights reveals
What DataLily Insights reveals about Medicare
Every benchmark below runs across more than 100 billion data points spanning over 10 million providers, so you see Medicare the way the market actually pays.
Negotiated and allowed rates by CPT and market
See what Medicare negotiates and allows for the CPT and HCPCS codes you bill, broken down by local market. Rose shows where Medicare sits richer or leaner on a procedure and how its allowed amounts move from one area to the next, so you can compare your contracted rates against the benchmark that actually matters.
Payer mix and share
Understand how much of your book runs through Medicare and how that share compares to other plans in your market. Rose maps Medicare's presence by specialty and geography so you can size what a Medicare contract is really worth to your practice.
Geographic and specialty strength
See the markets and procedure families where Medicare concentrates nationwide as the federal benchmark every commercial contract is measured against. Rose surfaces where Medicare runs strong and where it runs thin, so a contract conversation lands where it counts.
Are you underpaid versus peers
Put your own Medicare rates next to what comparable providers are paid for the same codes in the same market. If a gap exists on your high-volume procedures, DataLily Insights flags it and shows the size of the difference in dollars.
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Questions to ask Rose about Medicare
Rose answers in plain language, charts the result, and ends with a recommendation. Bring one of these to a demo.
FAQ
Medicare reimbursement, answered
How does Medicare set rates?
How can I tell if I am underpaid by Medicare versus my peers?
Does Medicare pay the same rates everywhere?
How much of my patient volume comes through Medicare?
Can DataLily Insights benchmark Medicare for my specialty?
Related payers
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