Nodal Medical Benchmarking
Know what care should cost while you can still change it
It's hard to improve what you can't measure. Nodal gives workers' comp the outside standard it's been missing, so you can spot inefficient care before it's too late.
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Workers' comp has always been measured by workers' comp.
Understand exactly how much workers’ comp care should cost
Nodal Medical Benchmarking compares each open claim against the healthcare data of one in three Americans, so you can identify unusually high treatment and medical costs while there’s still time to act.
Compare providers fairly
Provider performance
Make referral and network decisions on evidence, not reputation
Providers are scored on a risk-adjusted basis, so referral and network decisions rest on measurable performance instead of reputation.
Measure like against like
Risk-adjusted benchmarking
Compare claims on equal footing
Nodal adjusts for diagnosis, surgery type, geography, age, and more, so a claim is measured against genuinely comparable claims, not a rough average.
Read the clinical detail
Readable medical data
Turn complex codes into categories you can act on
Diagnosis and treatment codes are grouped into clear categories, so your team reads every claim the same way.
Defend every call
Defensible decisions
Back every decision with actuarial-grade evidence
Every benchmark is grounded in Milliman’s actuarial methodology, so pricing targets and interventions hold up to scrutiny.
The only workers' comp benchmark built on group health data
Built for the way you handle medical spend
Insurance carriers
Nodal benchmarks medical treatment and provider performance against group health, so you can get ahead of rising medical costs with a credible external standard.
Self-insured employers
When the benchmarks show your medical coverage is consistently overpriced, Nodal gives you the evidence to take it out to bid, not just keep absorbing the cost.
Third-party administrators
Nodal gives you consistent, benchmarked medical oversight across every account, so you can show clients exactly where you're controlling spend and improving care.
Request a demo
See what you're overpaying for, while you can still act on it.
Tell us a bit about your claims operation and we'll set up a demo tailored to your book.
Frequently asked questions
How does Nodal Medical Benchmarking account for regional cost differences?
Nodal Medical Benchmarking uses risk-adjusted benchmarking that specifically includes geography as a key variable, alongside diagnosis, surgery type, and patient age. By comparing claims within the same geographic context, Nodal Medical Benchmarking ensures you are comparing “like-for-like” episodes. This precision allows claims leaders to verify that the outliers identified are real inefficiencies rather than standard regional price variations.
What makes the Nodal Medical Benchmarking dataset unique?
Nodal Medical Benchmarking is the only workers’ comp benchmarking tool built on Milliman’s proprietary group health database, which represents one in three Americans. Unlike internal tools that only reflect your own history, Nodal Medical Benchmarking provides a broader, credible external standard to determine what medical care should actually cost.
How does Nodal Medical Benchmarking help reduce medical spend?
By identifying overutilization and outlier treatment patterns while a claim is still open, Nodal Medical Benchmarking allows for an estimated 10% reduction in medical spend. The tool provides prospective visibility, enabling claims organizations to intervene and improve medical decisions before excess costs are finalized.
Can Nodal Medical Benchmarking be used to evaluate provider performance?
Yes. Nodal Medical Benchmarking scores providers on a risk-adjusted basis. This allows insurance carriers, TPAs, and self-insured employers to see which providers drive better outcomes and which are outliers. These insights help ensure that referral and network decisions are based on objective performance data rather than reputation or guesswork.
Is Nodal Medical Benchmarking appropriate for complex medical data?
Absolutely. Nodal Medical Benchmarking is built to handle complex medical data by grouping intricate diagnosis and treatment codes into clear categories that your team can actually act on. Because every benchmark is grounded in Milliman’s actuarial methodology, the targets set by Nodal Medical Benchmarking are designed to be defensible to boards, members, and stakeholders.
How does Nodal Medical Benchmarking support self-insured employers?
Self-insured employers pay every dollar of medical cost on their claims but lack the claim volume to judge whether that spend is reasonable. Nodal Medical Benchmarking provides an independent standard for what treatment should cost, giving employers the evidence to hold TPAs and managed care vendors accountable, and the leverage to take those services out to bid.
Is Nodal's benchmarking methodology actuarially sound?
Yes. Nodal’s differentiation is built on benchmarking workers’ compensation activity against Milliman’s proprietary group health dataset, bringing a level of actuarial discipline and transparency to medical decision-making that internal data alone cannot provide.
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