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Home / News & IndustryManaged Care Insight and Analysis
Updated: July 21, 2009
Study: Physician Performance Can Be Tiered Using Measure Composites

The performance of physician practices can be reliably measured by using a composite of quality measures, according to research led by Sherrie Kaplan, PhD, MPH of the University of California at Irvine and co-authored by National Committee for Quality Assurance Executive Vice President Dr. Greg Pawlson.

Published in Medical Care, the findings – that used data from NCQA-recognized physicians – suggest that physician practices can be distributed into three levels of relative quality (high, average, low) when a cluster of measures, rather than a single measure, is used to differentiate performance.

Researchers used data submitted by physicians who were recognized in the NCQA Diabetes Physician Recognition Program (DPRP). Using a sample of 35 patients from each practice, the research team analyzed data from 11 diabetes measures. They found that combining performance on five to nine measures could reliably separate practices into three levels of quality.

"This research suggests that evaluating physician practices for pay-for-performance or similar programs can be a sound process when based on selected measure composites," said Pawlson. "As we move further into the widespread use of evaluation at the physician practice level, careful testing and evaluation of the evaluation methodology is critical for ensuring that the information is accurate and draws fair conclusions. Composite measures appear to offer a substantial advantage over individual or unrelated measures in this effort."

Evaluation programs need to use a carefully selected set of measures to be meaningful. "Our study underscores the importance of setting thresholds for the measures that reflect the degree of physician influence or impact on the measures," said Kaplan. "Identifying thresholds that reflect physician impact in contrast to the influence of the other factors, like patient characteristics, is of critical importance for fair and reliable performance assessment."

Address; National Committee for Quality Assurance, 1100 13th Street NW, Suite 1000, Washington DC 20005; (202) 955-3500, www.ncqa.org.


  This article was taken from:
Pay-For-Performance Reporter

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