See the opportunities in
your practice’s Medicare data.
Ellward Provider Opportunity Intelligence analyzes publicly available Medicare fee-for-service utilization associated with provider NPIs to identify potential clinical service opportunities, with modeled values and transparent assumptions.
This is a provider-level, public-data assessment — distinct from patient-authorized records. It does not analyze your complete patient panel, private patient records, all payer contracts, or confirmed clinical eligibility.
How It Works
From NPI to a prioritized shortlist of services to evaluate.
Analyze
We analyze publicly available Medicare utilization for a provider.
Identify
We identify clinical services that may be underused.
Prioritize
We prioritize opportunities using modeled annual values and stated assumptions.
Review
We review the findings with Ellward to decide what warrants further investigation.
What the Assessment Includes
A provider-specific assessment built for decisions.
A provider-specific summary of where clinical services may be underused, written for practice leadership.
Provider-level Medicare utilization findings, presented in context so your team can interpret them.
Modeled annual values for each potential opportunity, framed as planning estimates — not revenue you are currently losing or will recover.
The assumptions behind every estimate, shown alongside it so your team can evaluate them.
A structured review of the findings with Ellward to decide which opportunities merit further evaluation.
Depending on the provider, the assessment may look at services such as:
Evaluated only where relevant to the provider's practice and patient population.
The current assessment uses publicly available Medicare utilization and planning assumptions. It is not an analysis of your practice's complete patient panel or all payer contracts.
Illustrative Example
What one assessment looked like.
Illustration from one provider — not an expected or guaranteed result. This example is shown to illustrate the format of an assessment, not to suggest what your practice will find.
The services evaluated — and which are worth pursuing — vary by provider. Not all 14 services evaluated in this example would be appropriate for every practice. Findings are a starting point for a conversation, not a recommendation to act.
Opportunity estimates are for strategic planning and are not guaranteed revenue. Clinical eligibility, service delivery, coverage, billing, and reimbursement require practice-specific review.
Who It’s For
Built for teams evaluating clinical programs.
Physician practices
Understand where clinical services may be underused across your providers before committing to a new program.
Multispecialty groups
Compare provider-level findings to see where a clinical program is most likely to gain traction.
Healthcare organizations
Evaluate clinical programs with modeled opportunity values and the supporting utilization information behind them.
Provider Opportunity Intelligence is an assessment and decision-support service. Ellward does not operate RPM, CCM, behavioral health, or other implementation programs through this product.
What you can actually see
A concrete, provider-specific report — not a vague score.
Below is a preview of the structure of an Ellward assessment, shown with clearly labeled sample data. Every real assessment is provider-specific and reviewed with you before you act on it.
Ellward Health
Provider Opportunity Assessment
Provider
Sample Provider 004 — Internal Medicine, single-provider practice (de-identified)
Provider opportunity summary
Service-level opportunities
| Service area | Modeled annual estimate | Supporting utilization |
|---|---|---|
| Annual Wellness Visits | $38,000 – $52,000 | 21% of eligible beneficiaries seen |
| Chronic Care Management | $46,000 – $68,000 | 40 patients currently enrolled |
| Remote Patient Monitoring | $24,000 – $41,000 | No current program identified |
| Behavioral health integration | $10,000 – $13,000 | Limited visit volume recorded |
Planning assumptions
- Medicare fee-for-service utilization, latest published data year
- Estimates assume 60–80% of eligible patients engage over a full year
- Excludes commercial, Medicaid, and Medicare Advantage payer contracts
- Assumes services are delivered under the practice's existing infrastructure
All figures above are illustrative sample data for demonstration only. Modeled opportunities are planning estimates, not guaranteed revenue.
How you would use the findings
Review the findings with Ellward
A 30-minute findings review walks through what was found, what it means, and how confident to be in each estimate.
Choose one or two opportunities to evaluate
Most practices do not act on everything at once. The report is built to help you decide what comes first.
Confirm feasibility before acting
Clinical eligibility, coverage, and staffing are practice-specific. Treat the estimates as planning input, not committed revenue.
For sales and growth teams
A commercial application — not a bigger version of a physician report.
Commercial intelligence is built around a working pipeline: evaluate providers across a market, focus outreach where the modeled opportunity is largest, and bring provider-specific findings into account conversations. Final scope and price are set by agreement.
Evaluate provider prospects
Screen a market or account list for providers whose Medicare utilization patterns suggest unmet service opportunities.
Prioritize outreach
Rank prospects by modeled opportunity so your team spends time where the findings say it matters most.
Use findings in account conversations
Walk into conversations with provider-specific context — the services, the utilization story, and the assumptions behind each estimate.
Pricing
Choose how you want to use provider opportunity intelligence.
Start with one provider. Expand across your practice or market.
Provider Opportunity Assessment
A physician or practice evaluating a single provider
Find the clinical-service opportunities indicated by one provider's Medicare utilization.
Covers one provider, one time. No refresh included.
Includes
- A provider-specific opportunity assessment
- Service-by-service modeled annual values
- Supporting utilization and planning assumptions
- A 30-minute findings review with Ellward
Individual Provider
One provider using the intelligence directly
Track and revisit opportunities for one provider as new information becomes available.
Includes
- Access to that provider's opportunity assessment
- Quarterly updated assessments
- A view of changes from prior assessments
- An annual opportunity review with Ellward
Covers one provider, updated quarterly, for one year.
Small Practice
A small practice with up to five providers
See opportunities across your providers and decide which programs deserve attention first.
Includes
- Assessments for up to five providers
- Quarterly updates for included providers
- Provider-by-provider and practice-level opportunity views
- An annual practice opportunity review with Ellward
Covers up to five providers, updated quarterly, for one year.
Commercial Intelligence
An organization evaluating providers across a market or sales team
Use provider opportunity intelligence to prioritize a market and prepare more relevant account conversations.
Includes
- Analysis of an agreed number of provider NPIs
- A ranked view of provider opportunities
- Provider-specific assessments for outreach and account planning
- Access for an agreed number of team members
Scope set by agreement: NPI volume, seats, and refresh allowance.
Enterprise / Private Label
Multiple teams, markets, or a separately branded offering
Bring provider opportunity intelligence to multiple teams, markets, or a separately branded offering.
Scope may include
- Larger provider volumes and multiple territories
- Organization-level reporting
- Multiple customer or team environments
- Private labeling and custom delivery requirements
Final scope and price are set by agreement.
Commercial pricing depends on provider volume, number of users, markets covered, and agreed usage. Final scope and price are set by agreement.
Quarterly updates reflect Ellward's scheduled review cycle. Underlying Medicare data is published by CMS on its own schedule and may not have new information available at every quarterly review. Opportunity estimates are for strategic planning and are not guaranteed revenue. Clinical eligibility, service delivery, coverage, billing, and reimbursement require practice-specific review.
Compare your options
What each option covers.
The assessment and ongoing licenses are built for different uses. Entitlements below match what each pricing option already states.
| Dimension | Assessment | Individual license | Practice license | Commercial license |
|---|---|---|---|---|
| Intended buyer | A physician or practice evaluating a single provider | One provider using the intelligence directly | A small practice with up to five providers | An organization evaluating providers across a market or sales team |
| Provider / NPI allowance | One provider per assessment | One provider | Up to five providers | Set by agreement |
| Report volume | One provider-specific report | One provider report, updated quarterly | Up to five provider reports, updated quarterly | Set by agreement |
| Refreshes or reruns | One-time — no refresh included | Quarterly refresh | Quarterly refresh across included providers | Set by agreement |
| Users | One user | One user | Practice-wide access (up to 5 providers) | Set by agreement |
| Delivery format | Written report plus a 30-minute findings review | Quarterly written reports plus an annual findings review | Quarterly written reports (practice-level view) plus an annual findings review | Set by agreement |
"Users" reflects intended single-provider or practice-wide use based on each license's scope; final seat counts for the Commercial and Enterprise tiers are set by agreement. Enterprise / private label agreements are scoped individually. Quarterly updates reflect Ellward's review cycle and depend on CMS data availability. Opportunity estimates are planning estimates, not guaranteed revenue.
A Separate, Proposed Capability
Patient-level opportunity intelligence
The current assessment works from provider-level public Medicare data. The proposed next step reviews available patient-authorized records — accessed through MyMDHub with the patient's own authorization — to identify potential service opportunities for clinical evaluation, with findings revisited as information changes.
Patient-level intelligence through MyMDHub — contact Ellward to discuss availability.
This is a proposed capability, not a completed integration or part of an existing Provider Opportunity Intelligence license. It does not promise confirmed eligibility, automatic enrollment, reimbursement, or access to identifiable patient records for commercial prospecting.
Request an Assessment
Start with one provider or a handful.
Tell us a little about your practice and we’ll follow up to discuss the assessment.