Physician cost profiling--reliability and risk of misclassification.

ABSTRACT:

Background

Insurance products with incentives for patients to choose physicians classified as offering lower-cost care on the basis of cost-profiling tools are increasingly common. However, no rigorous evaluation has been undertaken to determine whether these tools can accurately distinguish higher-cost physicians from lower-cost physicians.

Methods

We aggregated claims data for the years 2004 and 2005 from four health plans in Massachusetts. We used commercial software to construct clinically homogeneous episodes of care (e.g., treatment of diabetes, heart attack, or urinary tract infection), assigned each episode to a physician, and created a summary profile of resource use (i.e., cost) for each physician on the basis of all assigned episodes. We estimated the reliability

SUBMITTER: Adams JL 

PROVIDER: S-EPMC2878194 | biostudies-literature | 2010 Mar

REPOSITORIES: biostudies-literature