New Analysis Finds Fundamental Flaws with Study on “Physician Value”

June 25, 2020

In a newly released white paper, Benefit Services Group, Analytics (BSGA) cautions that using incomplete data to rank physicians, as is done in a study released last December, is unlikely to improve health care delivery but could lead to unnecessary market disruption and undermine other, more credible efforts to identify best practices. 
The original study was conducted by GNS Healthcare and funded by the Business Health Care Group (BHCG) and the Greater Milwaukee Business Foundation on Health. It used data from the Wisconsin Health information Organization (WHIO). In a webinar on June 17, BHCG again touted the results of the study, indicating they could be used to steer patients to specific providers, including “naming names” of providers listed in the study.
“Physicians support using robust data to evaluate and improve care delivery; health systems do that every day,” WHA Chief Medical Officer Mark Kaufman, M.D. said. “While the study’s intention to improve performance is laudable, unfortunately the study lacks the appropriate scientific rigor needed to be of much use in driving improvement.”
BSGA found several shortcomings in the study, including that it used only one year’s worth of data, which BSGA indicates is too short for credible analysis as most analyses use three to five years’ worth of claims data. The study excludes half of the state’s primary care providers, especially new physicians who have received the most current training from medical schools. The study also excludes 90% of the medical utilization provided by health systems. Importantly, Wisconsin is unique in that much of the care in the state is provided through integrated systems. This means that the primary care physician is part of an overall team that helps manage care for a patient. In ignoring that, the study could result in worse outcomes, fragmented care, and have the exact opposite effect of what is intended. The BSGA white paper was partially funded by the Healthy Wisconsin Alliance, Inc., an advocacy organization that informs the public about health care issues, attitudes and trends in Wisconsin and is affiliated with the Wisconsin Hospital Association.
If you have any questions, contact Dr. Kaufman or WHA Senior Vice President of Public Policy Joanne Alig

This story originally appeared in the June 25, 2020 edition of WHA Newsletter