Methodology version 1.3

How the CareScore works

The CareScore is a procedure-specific summary of publicly reported information about a physician, the facilities where they operate and the experience of their patients. It is a starting point for a conversation with a clinician — not a medical recommendation.

Components

Weights that produce the score

Procedure experience

Estimated annual procedure volume and peer percentile from CMS utilization data.

25%

Credentials & training

Board certification, fellowship training and license standing.

20%

Facility quality

CMS quality measures for the facilities where the procedure is performed.

15%

Quality & outcome indicators

Published complication and readmission measures where available.

15%

Patient experience

Procedure-specific reviews and experience sub-ratings.

10%

Safety & regulatory record

State board actions, license restrictions and federal exclusions.

10%

Transparency & completeness

How complete and recently verified the underlying record is.

5%

Insurance participation and cost are shown separately and never affect the clinical score. Each score carries a confidence level (HIGH / MEDIUM / LOW) based on data completeness, and every methodology version is retained so historical scores stay reproducible.

Provenance

Sources and freshness

NPPES

Provider identity, NPI, taxonomy, practice locations

Updated 3 days ago

CMS Care Compare

Clinician quality measures and utilization

Reporting period ending June 2026

CMS Hospital Compare

Facility quality, complications, readmissions

Updated 21 days ago

Georgia Composite Medical Board

License status and disciplinary actions

Updated 3 days ago

CMS Open Payments

Industry and manufacturer relationships

Program year 2025

Hospital price transparency files

Normalized negotiated rates by facility and payer

Updated 34 days ago

Payer directory files

Provider network participation

Verified 7–160 days ago by plan

Docvera verified patient reviews

Procedure-specific patient experience

Current

Trust rules

Principles applied from launch

  • Advertising and premium profiles never change a CareScore or ranking.
  • Physicians cannot pay to remove verified negative public information.
  • Allegations are never displayed as findings: filings, dismissals, settlements, judgments and board actions stay distinct.
  • Serious disciplinary or litigation records are never attached to a physician on fuzzy name matching alone; low-confidence matches go to manual review.
  • Missing information is never treated as negative — it is labeled as not found in monitored sources.
  • Every material data point shows a source and a last-verified date.
  • Facility quality measures describe the facility, not the individual physician.

Identity resolution

How records become one physician

NPI exact matchLicense + stateName + locationName + specialty + organizationProbabilistic match

Every match receives a confidence score. Matches below threshold enter a data review queue for manual verification before anything appears on a public profile.