• 13 May 2009

Integrated Healthcare Association (IHA)

Helping to measure and reward physician efficiency.

Challenge:  To reduce soaring healthcare costs and rising insurance premiums while maintaining high standards for healthcare quality and patient satisfaction.

Solution:  Under contract to the Integrated Healthcare Association (IHA), Thomson Reuters is developing physician-group efficiency measures for incorporation into IHA’s California Pay-for-Performance program, applying the measures to health plan data, and disseminating actionable reports. Thomson Reuters has received and integrated claims and enrollment data from seven health plans (more than six million lives) and is assessing efficiency performance for over 200 physician groups. The methodology involves complex disease severity and patient comorbidity risk adjustment and uses both population and episode-based approaches (using the Thomson Reuters Medical Episode Grouper).

Results:  This project is one of the first and largest attempts to measure and financially reward physician efficiency. This project is still in its second phase, which involves formal testing, refinement, and validation of measures.