Physician Quality Profiling
Resolution Health has more experience with physician quality profiling than any other company in the country, having analyzed data for more than 27 million people from more than 60 employers and 15 health plans.
Physician Quality Profiler can improve quality of care
- Improve transparency of physician quality
- Increase physician compliance with evidence-based guidelines
- Support pay-for-performance programs
- Support design of tiered, performance-based provider networks
Physician Quality Profiler compares performance of different physicians in a statistically meaningful way
- Uses claims data to evaluate quality of care delivered by individual physicians and physician groups
- Carefully attributes responsibility for the management of each covered health plan member’s clinical issues to the appropriate physicians
- Provides state-of-the-art statistical analyses to support quality profiles
Complete Reporting Package
Provider-specific Quality Reports
- Quality score and profile, by quality measure, are created for individual physicians and physician groups
- Physician performance is evaluated within single health plan or across multiple plans
Condition-specific Quality Reports
- Composite scores by clinical condition (e.g., diabetes) or type of care (e.g., prevention) can be created for physicians or physician groups
Member-specific Detail
- Health plan members whose care was not consistent with best practice guidelines are identified, allowing providers to validate findings and improve performance
Physician Quality Profiler employs 103 clinical performance measures
Quality measures are based on widely accepted, evidence-based clinical practice guidelines and include measures endorsed by the Ambulatory Care Quality Alliance and National Quality Forum that can be applied to claims data.
Physician Quality Profiler offers health plans an approach for evaluating physician quality that is consistent with the New York State Attorney General’s requirement.
Physician Quality Profiler addresses care related to 20 clinical specialties
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