physician profiling

physician profiling

Managed care A method of cost containment that focuses on the patterns of health care provided by a single physician or group, instead of on specific clinical decisions; the resulting profile is then compared to other norms based on practice–ie, other physicians' profiles or to standards of practice–practice guidelines. See DRGs, Shrinkage factor.
Mentioned in ?
References in periodicals archive ?
In this role, he was responsible for managing all network management functions including provider contracting, physician profiling, value based payment models, and network operations.
Elsevier, a world-leading provider of scientific, technical and medical information products and services, will present new and enhanced analytic and clinical integration solutions at the Healthcare Information Management and Systems Society (HIMSS) annual meeting in New Orleans, March 4-6, including a new Physician Portal and expanded Physician Profiling as part of its enhanced MEDai Navigator.
Other commonly used cost-containment measures include requirements to obtain imaging within a "network" of providers that contract with a health plan, "certificate of need" laws in states to match the supply and demand of advanced imaging technology, and physician profiling that might exclude certain physicians from participation if they have high imaging costs.
Attributing services to a particular physician is extremely important in specifying a reliable and valid physician profiling system.
Employers caught in a profit squeeze are among the key players in a hard, new push for physician profiling.
In the project reported here, our purposes were to determine whether some risk-adjustment methodologies used for physician profiling are more accurate than others, and whether risk-adjustment differences lead to different judgments about PCP practice efficiency.
Published monthly also via PDF, the letter includes case studies, data gathering and analysis strategies, physician profiling and performance enhancement methods, and care plans, clinical algorithms and performance benchmarks.
Physician profiling will provide Floridians greater access to critical information and that will enable them to make more informed choices about health care practitioners.
Diedre Cummings, consumer program director for the Massachusetts Public Interest Research Group, said that proposals for similar physician profiling legislation are being considered in at least two other states.
This methodology has been already adopted by several of the physician profiling specialty HCDAS.
Physician Profiling to Measure Clinical Performance
Other measures include requirements to obtain imaging within a "network" of providers, "certificate of need" laws in states to match the supply and demand of advanced imaging technology, and physician profiling that might exclude certain physicians who have high imaging costs.

Full browser ?