Actuarial Notes

Episode-Based Physician Profiling: A Guide to the Perplexing

By Lewis G. Sandy, Mark C. Rattray and J. William Thomas · Springer · 2008 · GH301-102-25

Study guide: Exam GH-301

A perspective article in the Journal of General Internal Medicine (volume 23, issue 9, September 2008, pages 1521-1524). Its abstract describes episode-based profiling as a new "second generation" of physician profiling that measures physician practice at the "episode of care" level using claim and other administrative data sets, moving beyond legacy "first-generation" profiles based on population health and preventive services measures, and notes its advantages and its analytic and engagement limitations.

On the syllabus

  • Exam GH-301 — Provider Contracting and Reimbursement, outcome 1c; the whole article.

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