Reformulating provider profiling to improve patient outcomes: grouping providers treating similar populaltions of patients prior to evaluating performance

The current approach for provider profiling has significant limitations that deserve immediate attention due to the extensive repercussions profile reports have on the health care system. The long-term goal is to improve the current methodology for profiling providers by addressing some of its most pressing limitations. Since performance estimates are only valid when there exists sufficient overlap in patient characteristics, a substantial limitation with the current approach is its failure to assess the extent of patient covariate overlap among providers being profiled. The overall objective for this application is to implement a methodology that identifies similar groups of providers based on the admission characteristics of the patients they treat. The conjecture is that providers will need to be assigned to multiple groups to achieve sufficient overlap in patient characteristics and that, upon grouping providers, conclusions regarding provider performance will differ from conclusions under the current approach. Addressing this significant limitation provides a novel framework from which other researchers can build from to continue refining the current approach.