Adjust utilization for case mix and make physicians responsible for remaining variation

Published: February 1, 1998
Category: Bibliography > Papers
Countries: United States
Language: null
Types: Care Management
Settings: Health Plan, Hospital

Data Strateg Benchmarks 2:25-28.

“But my patients are sicker!” Health Source/CIGNA put a stop to this physician complaint by switching to quarterly physician profiles that are case mix adjusted using clinical algorithms based on ICD-9 diagnosis codes. The new method levels the playing field, and helps to more accurately identify inefficient use of services. A sample physician profile is included in this report.

PMID: 10345360

Resource Utilization,Practice Patterns Comparison,United States,Case Management,Baltimore,Diagnosis-Related Groups/classification,Diagnosis-Related Groups/economics,Needs Assessment,Utilization Review

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