Understanding Insurer-Provided Profile Reports

Earlier this month, the American Medical Association (AMA) released a new teaching guide to help physicians review insurer-provided practice data and use the information for practice improvement.
 
The guidebook, Take Charge of Your Data, helps you understand and verify the accuracy of the data reports that public and private health insurers use to construct your rating profile for public reporting, pay-for-performance, physician tiering and/or narrow network programs, as well as help you use that data for practice improvement opportunities. Using practical information and instructions, Take Charge of Your Data simplifies the process of reviewing profile reports and helps you better use the data to provide your patients with the highest quality of care.

“It is increasingly important that physicians be able to confirm the accuracy of the practice data collected by insurers since this information is used to drive public reporting, pay-for-performance, physician tiering and narrow network programs,” said AMA President Peter W. Carmel, M.D. In a press release issued by the AMA. “Practice data must be accurate in order to be actionable, and the AMA’s new guide will help physicians ensure that only reliable information is the basis of any profile report.”

The guidebook was compiled by Howard Beckman, MD, an expert in using physician data to find practice variations and practice improvement opportunities, in conjunction with staff in AMA's Private Sector Advocacy unit.

Take Charge of Your Data was created to be used together with a Standardized Physicians Data Report, also created by the AMA, to encourage insurers to adopt a uniform format for physician data reports. The standardized report serves as a model reference for the AMA’s new guidebook. Combined, the two resources will teach you how to extract information and patterns from you own data reports provided by insurers.

The new AMA guidebook and the supplementary standard report are available free to all physicians.

For more information, visit the AMA’s newly updated Practice Management Center at www.ama-assn.org. Let us know what you think of Take Charge of Your Data. Email me at daniel@medicalofficetoday.com.