While most physicians provide care that falls within established guidelines, about one in ten provided more services than patients needed, according to a GAO study of recent Medicare data. The researchers found that inefficient physicians accounted for 10 percent of the primary care physician population and 2 to 6 percent of specialists.
To establish the efficiency measures, GAO researchers looked at the physician profiling systems used by 10 health care purchasing organizations. Researchers then focused in on three profiling programs that produced savings. The programs that worked, researchers found, were ones that tied the outcome of profiling to incentives, such as noting in physician directories if a given doctor had met efficiency and quality standards, grouping physicians into tiers, providing bonuses or imposing penalties for inefficient or low-quality care.
To get more detail on GAO's research:
- read this CCH Medicare piece