Ama Policy

Collection and Analysis of Physician-Specific Health Care Data H-406.997

03/13/2019
Profiling

1. Our AMA advocates that third party payers, government entities, and others that collect and analyze physician-specific health care data adhere to the following principles:

(a) The methods for collecting and analyzing physician-specific health care data shall be disclosed to physicians under review and the public.

(b) Physician-specific health care data shall be valid, accurate, objective and used primarily for the education of both consumers and physicians.

(c) Data elements used in the collection of physician-specific health care data, including severity adjustment factors, shall be determined by advisory committees which include actively practicing, and where relevant, specialty-specific, physicians from the region where the data are being collected.

(d) Statistically valid data collection, analysis, and reporting methodologies, including establishment of a statistically significant minimum number of cases, shall be developed and appropriately implemented prior to the release of physician-specific health care data.

(e) The quality and accuracy of the physician-specific health care data shall be evaluated by conducting periodic medical record audits.

 

2. Our AMA believes that health care coalitions which include physicians as full voting members are an appropriate forum for undertaking health care data collection and analysis activities; in consideration of the potential for misinterpretation, violation of privacy rights, and antitrust concerns, it is recommended that charge or utilization data provided to such entities by government, third party payers, and self-insureds companies be in the form of ranges or averages and not be physician-specific.

 

Policy Timeline

BOT Rep. Q, I-92 BOT Rep. Y, I-85 Amended: CLRPD Rep. 2, I-95 CMS Rep. 10, A-96 Reaffirmation A-01 Reaffirmation A-05 Reaffirmed in lieu of Res. 724, A-05 Reaffirmed: CMS Rep. 1, A-15