Partnership research: reviewing private health provider performance measures
Melbourne Institute researchers are risk adjusting the performance measures for surgeons working in private healthcare to take into account their differing specialties and the types of patients they treat.
Risk Adjusting the Performance Measures of Health Care Providers in the Private Health Care Sector
A team of Melbourne Institute health economists are risk adjusting the performance measures for surgeons working in private healthcare to take into account their differing specialties and the types of patients they treat.
Commissioned by Medibank Private, the project follows the release of the Surgical Variance Report by the Royal Australian College of Surgeons and Medibank Private in 2016, which explored the variation in surgical practices within the Australian medical profession.
While the report highlighted significant practice variations, including cost, length of stay in hospital and re-admissions, for providers working in a variety of medical specialties, it did not account for the different patient complexity and severity.
By developing a risk adjustment methodology that takes patient case-mix into account, researchers hope to make it easier to draw more accurate conclusions about practice variations, which could be as a result of differences in patient case-mix rather than the performance of providers.
The key questions to be addressed through this research are:
- How to compare the performance of healthcare providers who may specialise in treating different types of patients?
- How to take into account the different case-mix of patients treated by different providers in constructing performance measures?
The research team will review the various approaches for risk adjusting performance indicators in the healthcare setting and recommend the appropriate approach for the performance measures reported in the Surgical Variance Report, which will then be implemented using administrative data provided by Medibank Private.
The research will also examine various options for the design, implementation and evaluation of possible interventions, with the aim of reducing or minimising practice variations.
Impact
This research is expected to contribute to a broader understanding of the sources of practice variations, enabling Medibank Private to devise strategies to reduce or minimise unwarranted practice variations among providers, and achieve better and more economical care outcomes for patients.
