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Using Consistently Low Performance to Identify Low-Quality Physician Groups.

Christina A Nguyen1,2, Lauren G Gilstrap3,4, Michael E Chernew2

  • 1Massachusetts Institute of Technology, Cambridge.

JAMA Network Open
|July 28, 2021
PubMed
Summary
This summary is machine-generated.

Consistently low performance across multiple quality measures and years can identify underperforming physician groups. This method helps target interventions to improve care quality for diabetes and cardiovascular disease patients.

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Area of Science:

  • Healthcare Quality Improvement
  • Health Services Research
  • Performance Measurement

Background:

  • Performance-based payment models are increasingly used in healthcare.
  • Assessing physician group quality is challenging due to noisy quality measures.
  • Consistent underperformance across measures or time may indicate low-quality groups.

Purpose of the Study:

  • To identify physician groups with consistently low performance.
  • The study focused on multiple quality measures for diabetes and cardiovascular disease (CVD).
  • Risk adjustment for patient characteristics was applied across multiple years.

Main Methods:

  • Cross-sectional study using claims and laboratory data (2016-2019).
  • Risk-adjusted performance estimated using mixed-effects linear probability regression.
  • Examined performance correlations across measures and time for 10 quality measures.

Main Results:

  • Analysis included 786,641 enrollees and 890 physician groups.
  • Year-to-year performance correlations were moderate to strong.
  • 11.1% of groups were in the bottom quartile for a measure across all 4 years.

Conclusions:

  • Consistently low performance across multiple years identifies a subset of physician groups.
  • This approach offers a novel method for identifying groups needing support.
  • Targeting resources to consistently underperforming groups can improve care quality.