Komodo Health: A Qualified Entity

Delve into Komodo’s Qualified Entity reports, which examine national provider performance across the clinical measures that are critical for improving health outcomes.

Komodo Health believes that smarter, more innovative use of data and analytics is essential for reducing disease burden. Core to our mission is the tenet that the insights generated using our solutions make an impact for the greater good, ultimately helping to identify and close gaps in care.

 

Komodo has the unique ability to generate insights from patient-level claims data reflecting all Medicare beneficiaries alongside broader commercial data in Komodo’s Healthcare Map®. These analyses of provider performance metrics shed light on health outcomes and clinical trends in the U.S.

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Komodo Health has adopted a new measure that looks at the use of diagnostic imaging following a low back pain diagnosis. Analyses were conducted to measure rate differences by age, sex, race, ethnicity, and insurance group.

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Reported rates continue to suggest that there remain a substantial number of patients who are at-risk for hyperglycemia and diabetes mellitus by virtue of their exposure to atypical antipsychotics, but are not being screened. The data suggest that the COVID pandemic may have created additional risk related to delay in identification or intervention for hyperglycemia or medication-induced diabetes.

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A new report by Komodo Health found overall diabetes screening rates have fluctuated for several years, suggesting that there may be a substantial number of patients who are at-risk for hyperglycemia and diabetes mellitus, by virtue of their exposure to atypical antipsychotics, who are not being screened.

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A new analysis found that although three-year DMARD dispense rates have increased overall, rates for Medicaid Managed Care and the Medicare-Medicaid Dual groups trended downward (as compared to 2018).

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Komodo Health conducted an analysis on whether patients with schizophrenia or bipolar disorder who were prescribed an antipsychotic medication had a diabetes screening during the measurement year.

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Komodo Health conducted an analysis of patients who were diagnosed with rheumatoid arthritis and received at least one Disease Modifying Anti-Rheumatic Drug (DMARD) during the measurement year.

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An analysis conducted by Komodo Health finds that a patient’s insurance type and the location of where the patient lives play a major role in prescription dispensing patterns, with only 54% of eligible patients with RA receiving potentially Disease Modifying Anti-Rheumatic Drugs (DMARDs).

 

According to an analysis conducted by Komodo Health, many patients who are prescribed medications that can disrupt normal serum glucose control do not receive annual screening for diabetes and other metabolic disorders.

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“Despite an onslaught of data in healthcare today, there is a surprising absence of insights that healthcare stakeholders can act on with confidence. We believe that healthcare needs a source of ground truth to close gaps in care delivery. Our ability to capture a more complete view of patient journeys enables Komodo Health to address disease burden through a richer understanding of public health.”

Arif Nathoo, MD

CEO, Komodo Health

Komodo Health has been certified under the CMS Qualified Entity (QE) Program since 2017. As a QE, Komodo Health is entrusted with claims data under Medicare Parts A, B, and D for use in evaluating the performance of healthcare providers in the U.S. health system. During its tenure in the CMS QE Program, Komodo has been systematically evaluating health system performance, access to care, and effectiveness in healthcare delivery across the entire payer landscape.

Komodo’s Healthcare Map® captures insights into 330 million patient journeys for a comprehensive view of de-identified patient encounters. Insights from the Healthcare Map, in combination with QE data, enable the company to model the epidemiology of disease and help health system stakeholders direct resources where they are needed most.

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