Concourse Sentinel

Medicaid Integrity Analytics

πŸ“ŠOverviewπŸ₯ProvidersπŸ’ŠProcedures🚨WatchlistπŸ”Statistical Outliersβš–οΈCompareπŸ“ˆTrendsπŸ—ΊοΈGeography

Cross-Dataset

πŸ•ΈοΈEntity Networks🏠Home Healthβ›”Exclusions (LEIE)πŸ“‹Context & Disclaimers
πŸ‡ΊπŸ‡ΈAll States
by Concourse

Data: CMS T-MSIS 2018-2024

Source: opendata.hhs.gov

Minnesota Medicaid Provider Spending

CMS T-MSIS data, 2018-2024

Concourse Sentinel connects to large-scale healthcare billing datasets β€” including CMS T-MSIS claims, provider enrollment (PECOS), and federal exclusion lists β€” and runs millions of automated statistical analyses to surface billing anomalies and areas warranting further review.

Cross-Dataset Analysis Available

Watchlist

447 critical

providers flagged

Home Health

Deep Dive

outlier analysis

Entity Networks

AO Analysis

shared ownership detection

Exclusions

LEIE Matches

post-exclusion billing

Total Spending

$25.3B

Total Claims

324.1M

Unique Providers

8.8K

Watchlist

1.8K

447 highest/critical risk

Monthly Spending Trend
Top 10 Providers by Spending
View all providers β†’
Spending by Category
Top 10 Procedures by Spending
CodeDescriptionTotal PaidClaims
S5140Adult foster care per diem$2.2B7.4M
T1019Personal care ser per 15 min$1.9B27.0M
T2031Assist living waiver/diem$1.3B7.6M
H0044Supported housing, per month$996.7M304.7K
H2035A/d tx program, per hour$820.6M6.7M
T2023Targeted case mgmt per month$814.7M1.7M
T2016Habil res waiver per diem$814.3M3.4M
99214Office o/p est mod 30 min$713.0M9.3M
H2036A/d tx program, per diem$695.9M574.6K
99213Office o/p est low 20 min$660.9M9.7M
View all procedures β†’