In an August 30, 2019 press release, CMS announced the launch of a new tool, which CMS has titled the “Market Saturation and Utilization Data Tool.” The tool is available here through the CMS website. CMS’s stated purpose for the tool is to monitor market saturation to help prevent potential fraud, waste, and abuse. In its press release on the tool, CMS defines market saturation in this context as “the density of providers of a particular service within a defined geographic area.” The data can be used to reveal the degree to which use of a service is related to the number of providers servicing a geographic region. CMS also stated that one objective of making these data public is to “assist health care providers in making informed decisions about their service locations and the beneficiary population they serve.”

The tool includes interactive data sets and maps that show national-, state-, county-, and Core-Based Statistical Area (CBSA)-level provider services and utilization data for selected health service areas and allow users to compare provider services and utilization data by geographic region. CBSAs are geographical delineations that encompass both metropolitan statistical areas and micropolitan statistical areas. A micropolitan statistical area is an urban cluster of at least 10,000 people but less than 50,000 people, while a metropolitan statistical area is an urban cluster of at least 50,000 people. CBSAs are Census Bureau-defined urban clusters of at least 10,000 people.

The new tool includes the following health service areas:

• Home Health;
• Ambulance (Emergency, Non-Emergency, Emergency & Non-Emergency);
• Independent Diagnostic Testing Facilities (Part A and Part B);
• Skilled Nursing Facilities;
• Hospice;
• Physical and Occupational Therapy;
• Clinical Laboratory (Billing Independently);
• Long-Term Care Hospitals;
• Chiropractic Services;
• Cardiac Rehabilitation Programs;
• Psychotherapy;
• Federally Qualified Health Centers;
• Ophthalmology;
• Preventive Health Services;
• Dialysis; and
• Telemedicine.

Additional information about the new tool and the methodology behind it can be found here.