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Activity Number:
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226
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Type:
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Invited
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Date/Time:
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Monday, August 3, 2009 : 2:00 PM to 3:50 PM
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Sponsor:
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Section on Health Policy Statistics
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| Abstract - #305814 |
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Title:
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The Relationship Between Reliability and Misclassification in Physician Quality and Cost Profiles
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Author(s):
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John L. Adams*+ and Ateev Mehrotra and J. William Thomas and Elizabeth A. McGlynn
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Companies:
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RAND Health and RAND Health and University of Southern Maine and RAND Health
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Address:
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1776 Main St., Santa Monica, CA, 90407,
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Keywords:
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Abstract:
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For pay-for-performance and network-tiering programs, health plans often profile physician performance using quality of care and resource use. There has been great interest in characterizing the reliability of these scores. Reliability in this application is typically based on a simple hierarchical linear model. This separates the observed variability in physician scores into two components: variability between physicians and variability within physician. Feedback to physicians may have different reliability standards than public reporting or network exclusion. We show the relationship between reliability and misclassification probabilities for several common rules used to map physician scores into reporting categories. Report cards giving providers one to three stars or systems flagging providers as high performing and statistical testing and percentile cut points are considered.
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