Managed care: provider profiling.

نویسندگان

  • P R Lee
  • R D Lasker
  • D W Shapiro
  • A B Bindman
چکیده

The Physician Payment Review Commission has examined the potential of profiling physician practice patPR. Lee and A.B. Bindman, Institute for Healty Policy Studies, University of California, San Francisco. P.R. Lee, D.W. Shapiro and R.D. Lasker, Physician Payment Review Commission. A.B. Bindman, Division of General Internal Medicine, San Francisco General Hospital. terns within the context oi cost containment and quality assurance. Profiling has the capacity to provide information about service use, quality of care, and costs. It uses epidemiological methods to document practice patterns and to compare the practice patterns of different providers. Profiling can be used to characterize the

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Quality Improvement in a Primary Care Case Management Program

In this article we describe and evaluate quality monitoring and improvement activities conducted by Massachusetts Medicaid for its primary care case management program, the primary care clinician plan (PCC). Emulating managed care organization (MCO) practices, the State uses claims to analyze and report service delivery rates on the practice level and then works directly with individual medical...

متن کامل

Profiling Resource Use by Primary-Care Practices: Managed Medicare Implications

Variations in elderly Medicare beneficiaries' health service use are examined using a 100-percent sample of fee-for-service (FFS) claims data from Alabama, Iowa, and Maryland. Provider specialty, group practice type, practice size, and location are found to be significant factors affecting hospital and ambulatory care utilization and cost, after controlling for patient and regional characterist...

متن کامل

Improving state Medicaid contracts and plan practices for children with special needs.

The rapid transition of state Medicaid beneficiaries into fully capitated managed care plans requires a special focus on children with chronic or disabling conditions, who often depend on numerous pediatric physicians and other specialty services for health care and related services. Because managed care arrangements for this population are growing in popularity nationwide, it is important that...

متن کامل

Regulatory restrictions on selective contracting: an empirical analysis of "any-willing-provider" regulations.

"Any-willing-provider" (AWP) laws compel managed care plans to accept any provider willing to accept the plan's terms and conditions, potentially undermining managed care's ability to constrain spending. However. AWP laws potentially respond to inefficient risk-selection by providers of managed care. With risk selection, observed reductions in expenditures in the managed care sector may be offs...

متن کامل

Economic and quality of life outcomes: managed care perspectives.

A variety of economic factors have created a growing demand for health care reform and the rapid expansion of managed care plans. Absence of a clear, commonly accepted definition of managed care constitutes one of the major difficulties in constructing a useful dialogue about managed care and its likely effects. This paper defines basic managed care models and outlines for each the degree of fi...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Journal of insurance medicine

دوره 24 3  شماره 

صفحات  -

تاریخ انتشار 1992