Forum Session

What Can Physician Profiling Do for Medicare?
July 13, 2007

Manager

Laura A. Dummit

Summary

This meeting explored the feasibility and utility of physician profiling in the Medicare program to address rising spending. Profiling, that is, comparing the average resource use of a physician’s patients to the resource use of other physicians’ patients, has been examined by the Government Accountability Office (GAO) and the Medicare Payment Advisory Commission (MedPAC). Although they used different methods, both organizations identified wide variation in the efficiency with which physicians deliver care. Based on its analyses and interviews with private payers, GAO recommended that Medicare adopt physician profiling techniques. This Forum session reviewed GAO’s recent report on profiling and its recommendation. In addition, one physician documented how his provider group has used profiling to improve quality of care, and another physician presented information about the use of profiling and concerns about the accuracy of physician comparisons.

Speakers

A. Bruce Steinwald, Director, Health Policy, Government Accountability Office; Eric Nielsen, MD, Chief Medical Officer, Greater Rochester Independent Practice Association; B. Dale Magee, MD, President, Massachusetts Medical Society

Slides from the presentations by Mr. Steinwald, Dr. Nielsen, and Dr. Magee are available for download.

Related Materials

See also the related publication (Issue Brief No. 825, September 10, 2007).

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