FoxIndex / Methodology
v.2026
Outfox Quality Signal

FoxIndex

Measure what matters: outcomes.

Not reviews or ratings. Clinical outcomes from real patient episodes, risk-adjusted and benchmarked locally.

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What we measure

Outcomes measured across the full episode of care.

Built from longitudinal claims data that captures what happens before, during, and after care.

Episode of care · structure Day 0 → Day 30–90
Trigger
Diagnosis or procedure
Care
Treatment, surgery, hospitalization
Recovery window
30–90 days, condition-dependent
Outcomes
What we measure
Complications Readmissions ER visits Length of stay Mortality (where applicable)
Day 0 The episode starts at the trigger event — the moment care begins.
Recovery window Length of the window depends on the condition. Knee replacement: 90 days. Acute MI: 30 days. Defined per condition, not arbitrary.
Outcome capture Every claim inside the window is attributed to the episode — even visits to other providers.
250+ episodes defined across acute, surgical, chronic, and behavioral conditions. Adapted from CMS BPCI episode definitions.
Methodology

Fair comparison, by design.

Six steps from raw claims to a simple quality tier. Risk adjustment ensures providers are evaluated fairly based on the patients they treat.

01
SourceReal-world, multi-payer claims
Built from commercial, Medicare, and Medicaid claims. Broad data allows apples-to-apples comparison across providers with different patient populations.
02
MeasureOutcomes across the episode
We track complications, readmissions, ER visits, and length of stay during the recovery window. Mortality is included where relevant.
03
AdjustRisk adjustment for patient complexity
Results are adjusted for age, comorbidities, HCC risk scores, prior utilization, and care setting. Providers are evaluated based on how their patients perform relative to expectations.
04
CompareObserved vs. expected
Performance is calculated as an observed-to-expected ratio. Below 1.0 indicates better-than-expected outcomes. Above 1.0 indicates worse.
05
BenchmarkSame specialty, same market
Providers are compared to peers in the same specialty and local market. This ensures fair, relevant comparisons.
06
TranslateSimple tiers and star ratings
Results are translated into clear tiers and star ratings so anyone can understand and act on them.
Better than peers
In line with peers
Worse than peers
Scale & coverage

Massive scale. Local precision.

Built on a massive multi-payer claims data set, enabling fair comparison within the same market.

100M+
People annually
National claims footprint
Multi-payer claims spanning commercial, Medicare, and Medicaid.
ProvidersClinicians evaluated
745,000+
Provider groupsPractices and physician organizations
267,000+
HospitalsAcute-care facilities
5,900
Surgical centersAmbulatory surgical centers
5,200
Episodes definedEpisodes of care defined
250+
Numbers reflect the active FoxIndex panel as of Q1 2026. Score generation requires a minimum case volume per provider per episode to ensure statistical reliability; providers below threshold are reported as insufficient data rather than being miscategorized.
Product

Cost and quality, shown clearly.
So better decisions are possible.

Price and quality aren't the same thing. A higher price doesn't mean better care, and the cheapest option isn't always the right one. FoxIndex shows both clearly so people can make informed decisions.

MR

Marcus Reyes, MD

Orthopedic Surgery Charlotte, NC NPI 1043•••
Quality score
4 / 5
Better In line Worse
Areas of expertise · Knee replacement (90-day) vs. peers in same specialty
Complication rate major + minor
Much better than peers
30-day readmission any cause
Better than peers
ER visit rate within episode
In line with peers
Plan contracted rate
$24,180Total knee replacement, all-in
Metro median
$31,64049 in-network options
Cost and quality, side by side · never blended
i Benchmarked against orthopedic surgeons in the Charlotte, NC metro market. Adjusted for patient risk: age, comorbidities, HCC, prior utilization, care setting.
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