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M odel for p rof IlI ng p Hys IcIans a cross d o MaIns methodology and valued the feedback as a fair assessment of their performance. The previous reward program ranked physicians on a small set of P4P measures and organizational incentives and lacked consistency across the members of the network. Additionally, the previous program did not measure all of the physicians in the managed care network. Health Clinic continued to use the case study profiling methodology in 2010 (with 2009 data) and 2011 (with 2010 data), at which time the funding was no longer available to support the rewards program. CONCLUSION In this article, we present a physician profiling method designed to produce reliable results, and we demonstrate its application at Health Clinic. The hierarchical composite model allows a diverse set of measures (i.e., process, outcome, structure, efficiency, and satisfaction) to be used at the individual or group level, thereby enabling broad profiling of individual clinicians. The model enables combining measures with disparate sample sizes, levels of difficulty, and variation, including measures that were individually unreliable for differentiating physician performance. The model is flexible and can accommodate change in future years, is transparent in terms of measurement, aligns with the organizational quality agenda, and is perceived as fair by targeted physician groups, thereby supporting key elements needed for useful physician profiling (Garnick et al., 1994). We also provide a foundation for additional work. While the resulting model at Health Clinic met design of c are expectations for reliability and purpose, future studies should examine case-mix adjustments and practice functionalities to improve validity. In addition, initiatives to create shared pools of transparent information for physician performance across insurers would provide more complete and accurate data and therefore improve the ability to profile physician performance. Finally, the model could be part of a participative weighting process in which clinics and physicians could choose their own improvement foci, increasing the relevance of the resulting model for participating physicians. REFERENCES Adams, J. L. (2009). The reliability of provider profiling: A tutorial. Santa Monica, CA: RAND Corporation. Adams, J. L., Mehrotra, A., Thomas, J. W., & McGlynn, E. A. (2010). Physician cost profiling-Reliability and risk of misclassification. New England Journal of Medicine, 362, 1014-1021. Berwick, D. M. (2009). Measuring physicians' quality and performance: Adrift on Lake Wobegon. Journal of the American Medical Association, 302, 2485-2486. Curtright, J. W., Stolp-Smith, S. C., & Edell, E. S. (2000). Strategic performance management: Development of a performance measurement system at the Mayo Clinic. Journal of Healthcare Management, 45(1), 58-68. Draper, D. A. (2009, June). Physician performance measurement: A key to higher quality and lower cost growth or a lost opportunity? Center for Studying Health System Change. Commentary 3. Retrieved from http://www.hschange.com/CONTENT /1064/1064.pdf Garnick, D. W., Fowles, J., Lawthers, A. G., Weiner, J. P., Parente, S. T., & Palmer, R. H. (1994). Focus on quality: Profiling physicians' practice patterns. Journal of Ambulatory Care Management, 17, 44-75. Hofer, T. P., Hayward, R. A., Greenfield, S., Wagner, E. H., Kaplan, S. H., & Manning, 235 http://www.hschange.com/CONTENT/1064/1064.pdf

Table of Contents for the Digital Edition of Journal of Healthcare Management - May/June 2014

Journal of Healthcare Management - May/June 2014
Contents
Interview With Christopher D. Van Gorder, FACHE, President and CEO of Scripps Health
Successful Strategic Planning for a Reformed Delivery System
You, Inc.
Assessing the Feasibility of a Virtual Tumor Board Program: A Case Study
Physician Clinical Alignment and Integration: A Community–Academic Hospital Approach
Employer-Based Coverage and Medical Travel Options: Lessons for Healthcare Managers
Composite Model for Profiling Physicians Across Domains of Care

Journal of Healthcare Management - May/June 2014