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.
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Applying the standard HLM to reliability calculations in this context would require an assumption of asymptotic normality of physician-level score estimates, which might not be tenable for physician profiling when the number of opportunities for physicians to pass quality indicators is small.
In future columns, I will discuss the impacts of UnitedHealth Group's misguided "lab benefit program" and the unfortunate Optum360 physician profiling software.
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.
Its individual physician profiling program began in 2002.
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.
Newer physician profiling software can provide reports at the network, group, specialty or individual level.
We also conduct physician profiling where we find the highest and lowest prescribing rates for generic drugs and look for the reasons why," he explained.
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.
These services include cost and quality-efficient drug distribution systems, standard drug utilization review, retrospective case management and physician profiling.

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