Stop guessing about whether you’re using the right specialty doctors.

Introducing Modus

Not a Standard Physician Rating System

A Guide to Specialty Doctors Quality and Cost Data Powered by 183 million Patients Claims

Can be Used Locally or Nationwide

Specialties We Cover

Musculoskeletal | Cardiology

Oncology | Gastrointestinal | Dermatology | Surgical Subspecialites (Coming Soon)

How is Modus Different?

Modus was founded by a practicing clinician with over two decades of deep frontline experience and knowledge of the market who was frustrated with the limitations with existing physician rating systems.

Modus is an intelligent, patented software solution that analyzes data from 183 million Medicare beneficiaries. We put that data through a clinical lens to find doctors who provide better care while lowering costs.

Analysis without that pragmatic clinical lens can be overwhelming and result in poor doctors’ choices.

Example for Orthopedic Surgery

Who We Serve



  • Employers
  • Health Plans
  • Physician Organizations


  • Finance, Benefits
  • Human Resources
  • Medical Directors
  • Care Navigators
  • Clinical Case Managers
  • Patients


  • Strategically design your benefit plan members cost sharing for any specialty doctor vs the trusted specialty doctors with track records of high quality and fair cost

  • Remove the guesswork—Your data may indicate that some specialty is a leading cost driver. We help you make intelligent choices instead of taking chances on a specialty doctor.

  • It takes years to gain trust with your members — build trust by providing them visibility into a doctor’s cost and outcomes



  • Employers
  • Insurers


  • Risk
  • Legal
  • Claims
  • Nurse Case Managers


  • Find high-quality doctors within your discounted network in Direction and Panel states, and influence your claims in Choice states

  • Reduce your medical, legal, and indemnity costs by choosing the right specialty doctors

  • Gain the trust of your injured workers by providing them visibility into a doctor’s quality outcomes

Beneficial Use Cases for the Modus Solution:

Finance and Benefits Administrators

use Modus for strategic plan design purposes to help select trusted physicians who are best suited for the benefits plan.

Care Coordinators and Nurse Case Managers

use Modus to navigate patients and help them select the right doctors nationwide.

Employees or Plan Members

use the Modus Doctors’ profiles on quality and cost to choose which specialist best meets their needs.

Insurance Underwriters

use our Doctors’ practice patterns index in any geography to inform your risk determination and pricing.

Success Stories

Modus saved our member from repeated surgery. Our members were going to doctors who said all the right things, but we did not have confidence that we would get a fair price and a good outcome.

– Benefits Manager for 2000 Employees

Initially our adjusters and RN Case Managers did not like the Modus ratings for 75 doctors in our Worker’s Comp network, but Modus Ratings was SPOT ON when we compared it to claims cost and return to work rate.

– Claims VP for National WC Insurer

Our clinical navigators used our relationships and knowledge with our local Orthopedics surgeons, but we struggled when our patients required out-of-state care, Modus did our homework to find out-of-state MSK doctors.

– Medical Director for a Regional Physician Organization

The Problem

How Do You Trust Your Specialty Doctor’s Motivation, Experience and Judgment?

  • 70% of specialty doctors surveyed believe that some doctors perform unnecessary procedures to profit from them.

  • Knowledge of doctors’ quality is based on subjective local data.

  • The choice of specialty doctor determines the patient’s quality and cost of care. Today this process is a gamble.

  • Payers are overwhelmed with vast data that keeps pointing to specialty doctors as the leading cost driver, what stats are meaningful?

  • Payers and patients lack experienced practicing doctors solving their SYSTEMIC CLINICAL CHALLENGES, so they revert to insurance or business analytical professionals who are trying to make sense of clinical data.

Why Modus

Clinical Leadership

Our proven data and software gurus are led by our clinician founder with over two decades of experience and still practicing medicine.

Most Comprehensive

A complete ranking of all specialty doctors and specialists using irrefutable results from 183 Million historical patient records. All Doctors are compared to their peers in the same specialty and geography.

Transparent Methodology

Quality and cost metrics with published numerator/denominator, Methodology.

Highest Accuracy

National Provider Identifier (NPI) level data for each doctor, and we analyze on average 5,400 actual billing codes verifiable with Medicare and refreshed monthly.


We created an industry-first capability of distilling a clear signal from the noise of massive data into ONE simple and actionable doctors’ performance rating.


We have no hospital or network affiliation.



Find Doctors Who Think Twice and Cut Once

Better care costs less because it’s measured, thoughtful, and well-planned to avoid harmful and expensive complications.

You’re looking for specialty doctors who serve the best interests of your people. Doctors who are thoughtful in weighing the benefits versus the risks for patients before exposing them to expensive and potentially harmful procedures.

Contact Us

Schedule a Free Consultation

Let us walk you through the benefits of our tool or get more information: