Provider Profiling: A Population Health Improvement Tool for the Southeast Military Health System
Abstract
Appropriate utilization of health care is the crux of managed care. It is also a key to success for the Southeast Military Health System (SEMHS). Profiling with Provider Perspectives, a Primary Care Management Tool, provides the SEMHS with a standardized performance measurement system that offers feedback in a user friendly and non-threatening format. This is accomplished without undue hindrance on patient care, through the maximization of automation, and requires minimal management overhead by the military treatment facility (MTF). The tool graphically displays opportunities to achieve efficiencies at the provider decision node: the point in the health care delivery continuum that has the greatest impact on where limited resources should be allocated to provide the most benefit. Profiling Primary Care providers at Martin Army Community Hospital (MACH) at Fort Benning, Georgia, effectively addressed the three essential components required to modify provider decision making and utilization management behavior: motivation, information, and a structured process. MACH, by empanelling beneficiary populations to individual Primary Care providers, is placing the onus on these providers to ensure more appropriate utilization of services such as emergency room visits and inpatient admissions, while maximizing preventive services, such as mammography screening and immunizations. The initial results indicate providers have enthusiastically embraced the population health/disease management profiling and the educational aspects of the tool. Additionally, analysis of selected preventive and efficiency performance measures suggests significant variation in the practice behavior between groupings of providers.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 01, 1999
- Accession Number
- ADA420806
Entities
People
- Phillip D. Pemberton
Organizations
- Academy of Health Sciences