Tag: Physician Ratings

Hospital Price Dispersion

Nov 18, 2010• 6

By DAVID DRANOVE, PhD

A study by the Center for Studying Health System Change that will be released today shows that hospitals receive different prices for treating the same diseases. Center President Paul Ginsburg says this about the findings:

“The variation in hospital prices found in this study are (sic) inconsistent with highly competitive markets—at least for markets outside of health care,” said HSC President Paul B. Ginsburg, Ph.D.,

Hospital markets may not be highly competitive, but this argument is silly. One might as well say “The variation in automobile prices is (not “are”) inconsistent with highly competitive markets.” But one would be wrong in either case.

Vertical quality differentiation (i.e., some sellers are better than others) generates price dispersion in competitive markets. It is only in the most basic treatment of competition — in the first week of an intro economics course — that vertical differentiation is ignored. Observed price dispersion is not incompatible with competition.Continue reading…

Rating the Raters: Physician Compare

Nov 18, 2010

By NAOMI FREUNDLICH

Let’s say you’ve enrolled in a new health insurance plan and need to find an internist who participates. How do you decide which doctor to choose? My (long deceased) grandmother made her choices by using the following criteria: She looked for a male doctor with a Jewish-sounding last name who graduated from an American medical school—preferably one located in New York City. Nowadays her narrow (and culturally biased) criteria would have excluded some of the most esteemed practitioners around.

If you are like most people, you don’t depend on your grandmother’s advice to find a physician, but rather ask friends, colleagues or other doctors for recommendations. But taking one person’s experience with an internist or surgeon as a signal that he or she is “really good” is still far from the optimal way to choose a practitioner.

Over the years, several commercial websites like HealthGrades and Angie’s List have cropped up that provide such consumer-friendly information as the distance a doctor’s office is from the patient, and whether foreign languages are spoken there. They usually include ratings that reflect consumers’ personal experiences with the practitioner. For people who want to dig deeper, most state medical boards collect data that can be searched to find out where your doctor went to medical school, where he did his residency and what board certifications she has. In some states you can also search to see if the doctor in question has received disciplinary action or been sued for malpractice.

This is a lot of on-line legwork for the average person—a task that even professionals can find difficult. Chip Amoe, assistant director for federal affairs at the American Society of Anesthesiologists told a group recently, “When I tried to go find a primary care physician, I couldn’t. You know, it was very difficult. I had to go on several different Web sites to be able to find [one].”

San Francisco 2010: iWantGreatCare Demonstration

Oct 17, 2010• 2

By Bianca Grogan

In the US, a growing number of doctor rating sites offer helpful – and unfortunately sometimes less than helpful – background information on physician performance. Healthgrades, Angie’s List, Vitals.com and a long list of start ups use a range of approaches and methodologies to provide comparative information on physicians, theoretically allowing users to make informed choices between providers, comparison shop for the best prices and avoid doctors with poor track records. In the UK, the independent iWantGreatcare.com takes a different approach, offering a stats driven glimpse into the performance of doctors working for the National Health Service (NHS). We like the site’s clean lines and ease of use, something we can’t always say about all its U.S. based competitors. In this presentation from October’s Health 2.0 Conference in San Francisco, iWantGreatCare’s Managing Director Neil Bacon talks about his firm’s approach and why nearly as many doctors as patients are using the site.

Physician Report Cards: Don’t Shoot the Messenger

Oct 11, 2010• 6

By JOHN R. MORROW

There is a BIG difference between the popular consumer/physician matching Websites such as: Vitals.com, RateMDs, Angies List, Healthgrades, Zagat and UCompareHealthcare (a NYTimes property), and the other initiatives in place to monitor physician performance as driven by hospitals, government and other payers and health plans. Soon, these differences will be merging with the more complex score cards from hospitals joining forces with the consumer tools.

OPPE (Ongoing Practice Performance Evaluation) and FPPE (focused Practice Performance Evaluation) are initiatives set in place by The Joint Commission (TJC), an arm of the American Hospital Association that accredits health care organizations. These initiatives are coming main stream to provide structured and frequent review of a hospital’s physician personnel. There is nothing new about these initiatives, (TJC has always been a follower in health care business intelligence), but soon ongoing reporting will be required by all and supplied by a variety of experienced commercial firms.

Private enterprise has been helping hospitals benchmark, profile and rate physicians on a broad spectrum of metrics relevant to specific acute service lines for decades. Of course mortality, length of stay, risk-adjusted complications rates, patient safety events and indicators, patient satisfaction, and a long list of Core Process Measures have all been part of that analysis. Progressive hospitals have been sharing this information with physicians, and for the most part physicians have accepted that the profiling analytics have done a good job of educating them on their performance. Medical Evaluation Committees have their hands full with information to help credential and reappoint physicians to hospital privileges, and a more informed dialog has been fostered.

Trust Me I’m a Doctor vs. Physician Quality Report Cards

Aug 21, 2010• 84

By KENT BOTTLES, MD

In Quality Measures and the Individual Physician, Danielle Ofri, MD, PhD, questions the usefulness of feedback report cards for individual providers. She states, “Only 33% of my patients with diabetes have glycated hemoglobin levels that are at goal. Only 44% have cholesterol levels at goal. A measly 26% have blood pressure at goal. All my grades are well below my institution’s targets.” (http://danielleofri.com/?p=1169)

It would be better for Dr. Ofri’s patients if these numbers were higher. I think even Dr. Ofri would agree with that assessment. And yet Dr. Ofri’s response to these low scores is that “the overwhelming majority of health care workers are in the profession to help patients and doing a decent job.” And more upsetting is Dr. Ofri’s conclusion where “I don’t even bother checking the results anymore. I just quietly push the reports under my pile of unread journals, phone messages, insurance forms, and prior authorizations.” (http://danielleofri.com/?p=1169)