Profiling primary care physician resource use: Examining the application of case mix adjustment

Anthony M. Tucker, Jonathan P. Weiner, Steven Honigfeld, Ronald A. Parton

Research output: Contribution to journalArticle

Abstract

Growing emphasis on managed care has led to increased interest in physician practice profiling. Standardized techniques for conducting profiling are not yet well established. One particularly challenging methodologic issue, case mix adjustment, is explored here using actual cost profiles derived from primary care physicians at two independent practice association (IPA)-model health maintenance organizations (HMOs). Specifically, this article examines how the ambulatory care group case mix methodology can be applied to profiling and illustrates that it provides more depth of information with which to assess performance than does standard demographic adjustment alone. This analysis suggests both the potential and methodologic limitations of profiling at the individual physician level.

Original languageEnglish (US)
Pages (from-to)60-80
Number of pages21
JournalJournal of Ambulatory Care Management
Volume19
Issue number1
DOIs
StatePublished - Jan 1996

Keywords

  • Case mix adjustment
  • Managed care
  • Methodology
  • Profiling

ASJC Scopus subject areas

  • Health Policy

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