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PubMed · 10138793

Using claims data to select primary care physicians for a managed care network.

P Nathanson·M Noether·R J Ozminkowski·K M Smith·B E Raney·D Mickey·P M Hawley
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Abstract

An insurance claims databased profiling system was developed to help select new primary care physicians (PCPs) for a managed care network. PCPs (family practitioners, internists, and pediatricians) were ranked based on how closely their actual use of outpatient services conformed to the predictions of a mathematical model that adjusted for differences in age, sex, and case mix.

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Ambulatory CareCredentialingData Interpretation, StatisticalDatabases, FactualDecision Making, OrganizationalDiagnosis-Related GroupsFemaleHumansInsurance Claim ReportingMaleManaged Care ProgramsPersonnel SelectionPhysicians, FamilyPractice Patterns, Physicians'United StatesWorkforceJournal Article

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P Nathanson, M Noether, R J Ozminkowski, K M Smith, B E Raney, D Mickey, P M Hawley. 1994. Using claims data to select primary care physicians for a managed care network.. https://pubmed.ncbi.nlm.nih.gov/10138793/

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