PROFESSIONWisconsin group to measure physician quality, efficiencyThe state's insurers, businesses and physicians have banded together to fund a vast claims data warehouse.By Kevin B. O'Reilly, amednews staff. Jan. 23, 2006. As early as 2007, Wisconsin could see its first public report analyzing the efficiency of physician practices based on a statewide repository of health insurance claims data. Here's the twist: Wisconsin physicians are the ones leading the effort. Doctors traditionally have been skeptical of health plans' efforts to rate how efficiently they care for their patients. They've often said the methodology is flawed, the sample sizes too small and insurers' motives suspect. But the newly formed Wisconsin Health Information Organization is looking to address those concerns and provide doctors with insight on how they can improve their practices' quality and efficiency. "That is precisely why we wanted to be at the table," said Wisconsin Medical Society Chief Operating Officer Linda Syth. "If you aren't part of the dialogue, you can't give input into how data are used or challenge wasteful, ineffective uses of the information." The medical society is one of nine insurer, business and physician groups that founded WHIO in November 2005. With large insurers such as Blue Cross Blue Shield of Wisconsin, Humana and UnitedHealthcare of Wisconsin participating, the repository will have claims data for about half of the state's privately insured patients. The creators' hope is that smaller plans also will contribute. Clyde "Bud" Chumbley, MD, CEO of the physician-owned Medical Associates Health Centers, based in Menomonee Falls, Wis., wants WHIO to have a big enough sample size to present some valid efficiency data to the marketplace, something he said is lacking now. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2006 American Medical Association. All rights reserved.
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