January 2026: The Top Three
1. PRS drives Best Hospitals of 2026 by Money.com
Best Hospitals of 2026
For the 3rd year running, Money.com (formerly Money Magazine) partners with DDI to leverage Provider Ranking System’s (PRS) Composite Ranking Score for quality in their popular series, Best Hospitals. DDI’s PRS replaced Leapfrog as Money’s preferred partner for provider quality in 2023. Overall rankings are out for 2026, with specialty rankings now being released throughout the year.
Founded in 1972, Money provides up-to-date news, educational resources, and tools to help consumers make informed financial decisions, from investing and retirement to health care and insurance. See the rankings here.
1. PRS accelerates and expands claims data intake
PRS accelerates and expands claims data intake
We have accelerated and expanded our claims data intake for Provider Ranking System (PRS). Calendar year claims for 2024 are now in final QA, and will load into PRS in February. We immediately move to calendar year 2025 claims processing, which will be loaded into the system by mid-2026. We will then go to twice annual PRS update to reduce data lag to just six months, ensuring clients nearly real-time access to provider quality, directory and volume metrics.
The 2024 data load about doubles the reach of PRS in terms of total claims volume, now including all the three of the major US lines, Medicare, Commercial Health, and Medicare Advantage. The 2025 claims data load will add workers’ compensation claims to the PRS dataset. This is critical to our focus not only on quality healthcare and price transparency, but restoration of function and return-to-work for temporary disability and workers’ compensation claims.
3. Introducing the MLCR ("Mil-Sir"), a better way to RBP
Median Local Commercial Reimbursement
Reference-based pricing (RBP) has become popular in self-insured employer plans and has traditionally set fee-for-service reimbursement at ~1.4x Medicare rather than using negotiated network contracts or billed charges. This eliminates traditional provider networks, offering flexibility to see any provider while aiming for significant cost savings through transparent, lower payments.
Big downsides include “balance billing”, where providers bill patients the difference between the plan’s payment and their full, list rate (often 2-3 times their network rates), leading to surprise bills and massive financial risk to members. Additionally, providers often refuse low RBP plans, limiting access to care.
The MLCR from DDI’s Healthcare Pricing Guide (HPG) is the median, local, commercial reimbursement from the networks price transparency files. While typically higher than 1.4x Medicare (1.88 in example above), it is a fair price that provides nearly universal access without balanced billing. Even better, it avoids the big landmines in every network (multiples of 3, 4 and 5x Medicare).