Unbiased Analysis of Today's Healthcare Issues

How do commercial insurers evaluate physician quality?

Often, this is done with claims-based measures and beneficiary surveys. Today, I take a more detailed look at the UnitedHealth Premium physician designation program. The program evalutates physicians based on established quality measures and–for those who meet the minimum quality requirement–a measure of efficiency (i.e., low cost). A more detailed description is available here. Without […]

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How to Measure Physician Efficiency

Many payers are moving towards value-based purchasing programs that reward efficient physicians with additional payments and punish inefficient physicians with decreased payments.  Medicare’s Quality and Resource Use Reports (QRUR) are a step in this direction. However, summarizing overall physician quality is a difficult prospect.  First, the types of cases each physician treats is not homogeneous, […]

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