PEPPER Back After Two Years

By Tiffany Ferguson, LMSW, CMAC, ACM

The PEPPER is back.

After a two-year hiatus, hospitals once again have access to their Program for Evaluating Payment Patterns Electronic Report. If you haven’t seen it yet, your organization can log in here: https://pepper-file.cbrpepper.org/index.html#/login

Despite having two full years to modernize, the newly released PEPPER is 99% identical to prior versions.

• No new measures.

• No measures removed.

• No recalibration to reflect how care delivery has evolved.

So what does this mean for hospitals, physician advisors, and UM/CM?

First, a reminder worth repeating: Being an outlier does not automatically mean you are doing something wrong. PEPPER flags are statistical variation, not intent, quality, or appropriateness. Context, documentation, physician practice patterns, and patient complexity still matter.

Second, PEPPER should never be used in isolation. It is a starting point for inquiry. The real work happens when PEPPER data is paired with utilization review insight, physician advisor engagement, and service-line level analysis.

And for those newer to this space, a quick housekeeping note: the “R” in PEPPER stands for Report. Please don’t call it the “PEPPER report.” 😉

At Phoenix Medical Management, we view PEPPER as a tool for education, alignment, and proactive risk mitigation. Special thanks to Dr. Ronald Hirsch for the update!