Medicare Services

Medicare 5% Sample

The Reden & Anders Medicare 5% Sample Experience Trend Reports provide information on utilization, charge, Medicare allowed per service, and per member per month expense for service categories provided at the facility or by physicians.

Addressing the need for Medicare fee-for-service experience data.


Standardized reports

Reden & Anders has developed standardized reports containing the information described above by county, although requests are often for groupings of counties to enhance the credibility of results.

Medicare 5% Sample Experience Trend Reports consist of ten tables which provide the following information:

  • Tables 1 through 5 provide the following for a specific set of years:
    • Admits, days, visits, and unit volumes of service for facility, professional, and other service expense categories
    • Charges and Medicare reimbursed amounts for facility, professional, and other services expense categories
    • Utilization rates per thousand, members per year for facility, professional, and other services expense categories
    • Charges/reimbursed amounts per unit of service for facility, professional, and other service expense categories
    • Charge and reimbursed based per member per month expense for facility, professional and other service expense categories.
  • Tables 6 through 10 provide year-over-year trend summaries for utilization and PMPM expense for facility, professional, other services on an aggregate basis.

Customized reports

Reden & Anders can accommodate customized requests for reports which vary from the content of the standard reports. However, it should be noted that there are CMS-required minimums as to the data cell volume, which may preclude us from releasing all data elements in the report for customized requests.