MEDICARE Per Capita Method Can Be Used to Profile Physicians and Provide Feedback on Resource Use September 2009 GAO-09-

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What GAO Found

Using 2005 and 2006 Medicare claims data and a per capita methodology, GAO found that specialist physicians showed considerable stability in resource use despite high patient turnover. This stability suggests that per capita resource use is a reasonable approach for profiling specialist physicians because it reflects distinct patterns of a physician’s resource use, not the particular population of beneficiaries seen by a physician in a given year. GAO also found that our per capita method can differentiate specialists’ patterns of resource use with respect to different types of services, such as institutional services, which were a major factor in beneficiaries’ resource use. In particular, patients of high resource use physicians used more institutional services than patients of low resource use physicians.

GAO identified four key considerations in developing feedback reports on physician performance (see table).
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