Characterizing Physician Practice in Nursing Homes Using Claims-Based Measures: Correlation With Nursing Home...

Area of Science:

• Gerontology
• Health Services Research
• Health Policy

Background:

• Nursing home (NH) quality variations may stem from heterogeneous physician practice patterns.
• Obtaining data on the organization of physician practice within NHs is challenging.

Purpose of the Study:

• To characterize NH physician practice using claims-based metrics.
• To examine the relationship between these metrics and NH administrator-reported perceptions of physician practice.

Main Methods:

• Utilized 2011 Medicare Part B claims for 13,718 physicians treating patients in 2,095 NHs.
• Measured physician practice concentration via Herfindahl-Hirschman index (HHI) of visits.
• Assessed physician specialization by the proportion of visits to NHs.

Main Results:

• Median HHI was 0.44 (IQR 0.28-0.70); median specialization was 38.1% (IQR 19.9%-60.9%).
• NHs reporting higher physician specialization also reported more frequent physician participation in care coordination.

Conclusions:

• Claims-based measures, such as HHI and specialization, can effectively characterize NH physician practice.
• Physician specialization is linked to improved care coordination within NH settings.