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Profiling Efficiency and Quality of Physician Organizations in Medicare

This article presents a methodology for profiling the cost efficiency and quality of care of physician organizations (POs). The method is implemented for the Boston metropolitan area using 2002 Medicare claims. After adjustments for case mix and other factors, 4 of 30 organizations are identified wi...

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Detalles Bibliográficos
Autores principales: Pope, Gregory C., Kautter, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: CENTERS for MEDICARE & MEDICAID SERVICES 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195015/
https://www.ncbi.nlm.nih.gov/pubmed/18624078
Descripción
Sumario:This article presents a methodology for profiling the cost efficiency and quality of care of physician organizations (POs). The method is implemented for the Boston metropolitan area using 2002 Medicare claims. After adjustments for case mix and other factors, 4 of 30 organizations are identified with different than average efficiency Twenty-one of 30 organizations are identified with a different composite quality of care than average. Without changes in PO behavior, the gains from redirecting patients from lower to higher efficiency and quality providers are likely to be limited.