Benchmarking Physician Performance: Current Practice & Research Needs

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Local coalitions of health plans, employers, and physician organizations across the country are engaging in projects to improve health care quality by collecting and disseminating performance information about physicians and physician organizations. These efforts can focus on quality improvement initiatives, provide physicians information to benchmark their performance against others, offer consumers reliable and valid quality of care information for selecting providers, allow payers or purchasers to reward superior performance. There is substantial variation across these organizations in the measures and methods used to implement these measures, creating confusion for physicians and limiting opportunities for comparisons. Through a grant from the Commonwealth Fund, the National Committee for Quality Assurance (NCQA) is working with a national panel of physician benchmarking organizations to develop and test a complete set of implementation methods for physician-level measures of effectiveness and resource consumption to enable nationally standardized performance measure collection and benchmarking. A number of concerns have been noted in the research literature about methodological issues such as measurement reliability, risk adjustment and the potential for gaming. It is unclear whether organizations engaged in physician benchmarking are aware of these concerns and have addressed them in existing methods. There is a critical need to ensure that research knowledge that could improve current physician measurement efforts is shared with organizations and stakeholders that use physicians benchmarking data. NCQA will convene a conference in January 2006 to bring together physician benchmarking organizations and researchers to discuss draft consensus standards for measuring and benchmarking performance on effectiveness and resource utilization at the physical level. The goals are 1) To advise physician benchmarking organizations on a set of draft measure implementation rules for physician benchmarking efforts and 2) To draft a research agenda that will inform the improvement of methods for physician level measurement in the future. This conference directly addresses AHRQ's efforts to increase opportunities for knowledge transfer related to improving quality of care health for all Americans and offers a critical opportunity for AHRQ to stimulate knowledge transfer to users and to encourage efforts that will transform the health care system.