New AMA Resources Help Physicians Take Charge of Their Data

Increasing importance of physician data

It is often said that knowledge is power, and in our increasingly technology-based world of medicine, the primary source for obtaining that knowledge is data. All-payer claims databases, patient registries, patient satisfaction survey results, data analytics engines, electronic health records and a host of other systems and technologies are revolutionizing the way in which health care is chosen, delivered and funded.  Physicians are being publicly rated for the quality, cost and style of care they provide to patients, and payment mechanisms are increasingly being tied to prospective utilization budgets and measures of performance in an effort to control the ever-increasing cost of medical care.

As the collection of medical data is proliferating, it is becoming apparent that physician survival will be tied to owning, mining and understanding that data. Physicians must ensure that their information is responsibly reported by other parties, as well as learn to use data themselves for improving their practices and remaining relevant in the changing health care marketplace. It is critical that physicians begin to review and understand their claims and other data to:

1)      reduce health care costs by eliminating the currently inexplicable variation in treatment patterns;

2)      ensure that their publicly-reported practice profiles are accurate;

3)      improve the quality and efficiency of their practices; and,

4)      prepare themselves for the new budget-based payment models that depend on the variation between projected and actual use and cost of resources, rather than on maximizing volume of services

AMA physician data resources

To support physicians in this new, data-driven environment, the American Medical Association’s Private Sector Advocacy team has developed several educational tools. “Take Charge of Your Data is a new guide designed to help physicians understand and verify the accuracy of the complex profiling reports provided by public and private health insurers. Using practical information and step-by-step instructions, the guide simplifies the review of data reports and teaches physicians how to use both quality and cost-of-care data to identify practice improvement opportunities.

“Take Charge of Your Data was developed to be used in tandem with the AMA’s “Standardized Physician Data Report.” The AMA created the Standardized Report to encourage payers to adopt a uniform format for physician profiling reports. Currently, each payer uses its own unique format to report physician performance data, making it extremely challenging for physicians to decipher the reports from various insurers. The Standardized Report offers a uniform reporting format for payers’ physician data reports and includes the patient-specific detail needed for the reports to be meaningful and actionable for physicians. When used together, the physician guide and the Standardized Report can help physicians identify common report features; interpret quality and cost-of-care performance results; and, use the information to improve care and/or increase efficiency.

AMA’s “Guidelines for Reporting Physician Data (Reporting Guidelines)” were created in conjunction with many physicians, Federation of Medicine staff, national health insurers, accreditation bodies, and other organizations with an interest in health care. The Reporting Guidelines were designed to increase the uniformity of data reports so that these reports can be more easily understood by physicians. The Reporting Guidelines also promote the use of sufficient detail (i.e., patient-level information) in data reports so that physicians can verify the accuracy of the information and use the data for practice improvement. The AMA is urging all interested stakeholders, including health plans, to attest their support for the Reporting Guidelines. The AMA hopes that payers will incrementally adopt the principles outlined in the Reporting Guidelines, which will in turn facilitate better physician understanding and use of data reports.

Access AMA resources online

“Take Charge of Your Data,” the “Standardized Physician Data Report,” and the “Guidelines for Reporting Physician Data” are all available on the AMA’s website. Visit www.ama-assn.org/go/physiciandata to access these resources and a webinar about the guidebook with physician data expert Dr. Howard Beckman. And, if you haven’t already done so, sign up to receive the AMA Practice Management Alerts emails at www.ama-assn.org/go/pmalerts to stay up to date with information on unfair payer practices, ways to counter these practices and practice management resources and tools.



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