Is Physician Cost Profiling Ready for Prime Time?
Purchasers have been experimenting for some time with different approaches to reining in health care costs. One new approach is to focus attention on the relative costs of individual physicians and to give consumers incentives to seek care from physicians with lower spending patterns. Purchasers have developed methods called cost profiles, which are used to create overall assessments of practice patterns. A cost profile is a single number that places a physician on a relative scale of spending. Purchasers use cost profiles, in conjunction with quality profiles, to identify high-value physicians. In a typical system, patients pay a lower co-payment to visit a high-value physician. Creating a physician’s cost profile involves multiple steps and decisions. These include deciding which care will be included in a cost profile (e.g., whether preventive care be included), determining which costs are assigned to each unit of care, deciding which physician is responsible for care, identifying t
