GAO Finds Physician Profiling Can Work

The Government Accountability Office (GAO) has released a report showing that a per capita methodology, a method that measures a patient's resource use over a fixed period of time and connects that resource use to physicians, is "a useful approach" to profiling physicians on their practice efficiency. GAO also suggested that the approach could become part of a feedback program that includes quality measures and episode based resource-use measures. The study on per capita profiling was part of effort by the Department of Health and Human Services to develop a program to provide physicians with confidential feedback on the Medicare resources they used to provide care to Medicare patients. Using a per capita methodology to profile specialists, GAO found that physicians' patterns, as measured by the level of their resource use, were fairly stable over 2005 and 2006, in spite of high patient turnover. Additionally, the report found that patients seen by "high-resource use" physicians generally were heavier users of institutional services than those seen by lower resource use physicians. GAO noted that institutional services were the "major driver of Medicare expenditures," accounting for an average of 54% of expenditures. To view the report go to http://www.gao.gov/new.items/d09802.pdf