Abstract: A method for measuring physician efficiency and patient health risk stratification is disclosed. Episodes of care are formed from medical claims data and an output process is performed. Physicians are assigned to report groups, and eligible physicians and episode assignments are determined. Condition-specific episode statistics and weighted episode statistics are calculated, from which physician efficiency scores are determined.
Abstract: A computer system for identifying medical care providers outside a process-of-care standard for a field of health care is configured to perform steps that include retrieving claim line item information including procedure/service codes, and retrieving definitions for marker code groups associated with each of a set of medical conditions; deriving, for each marker-condition pair, an actual rate of utilization of the marker code group for episodes of the associated medical condition; and assigning a status to each marker-condition pair in response to the actual rate of utilization respectively exceeding or not exceeding a target rate. The steps also include aggregating the statuses across the marker-condition pairs to obtain an overall score, and causing an output to be displayed in a viewable format. The output includes the overall score, each marker-condition pair of the set of medical conditions, and the status for each marker-condition pair of the set of medical conditions.
Type:
Grant
Filed:
September 30, 2020
Date of Patent:
February 8, 2022
Assignee:
Cave Consulting Group, Inc.
Inventors:
Douglas G. Cave, Yuri Alexandrian, John Calvin
Abstract: A method for measuring physician efficiency and patient health risk stratification is disclosed. Episodes of care are formed from medical claims data and an output process is performed. Physicians are assigned to report groups, and eligible physicians and episode assignments are determined. Condition-specific episode statistics and weighted episode statistics are calculated, from which physician efficiency scores are determined.
Abstract: A method and system for producing statistical analysis of medical care information comprises: aggregating medical care providers to a peer group level; aggregating medical care information at the peer group level and at the medical care provider level; computing a statistical analysis, such as performing Pearson's correlation analysis; and generating peer group level and medical care provider level results utilizing the computed statistical analysis.
Type:
Grant
Filed:
May 23, 2016
Date of Patent:
December 15, 2020
Assignee:
Cave Consulting Group, Inc.
Inventors:
Douglas G. Cave, Yuri Alexandrian, John T. Calvin, Jenine A. Lara
Abstract: A method for measuring physician efficiency and patient health risk stratification is disclosed. Episodes of care are formed from medical claims data and an output process is performed. Physicians are assigned to report groups, and eligible physicians and episode assignments are determined. Condition-specific episode statistics and weighted episode statistics are calculated, from which physician efficiency scores are determined.
Abstract: A method and system for producing statistical analysis of medical care information comprises: aggregating medical care providers to a peer group level; aggregating medical care information at the peer group level and at the medical care provider level; computing a statistical analysis, such as performing Pearson's correlation analysis; and generating peer group level and medical care provider level results utilizing the computed statistical analysis.
Type:
Grant
Filed:
June 3, 2019
Date of Patent:
June 16, 2020
Assignee:
Cave Consulting Group, Inc.
Inventors:
Douglas G. Cave, Yuri Alexandrian, John T. Calvin, Jenine A. Lara
Abstract: A method for measuring physician efficiency and patient health risk stratification is disclosed. Episodes of care are formed from medical claims data and an output process is performed. Physicians are assigned to report groups, and eligible physicians and episode assignments are determined. Condition-specific episode statistics and weighted episode statistics are calculated, from which physician efficiency scores are determined.
Abstract: A method for measuring physician efficiency and patient health risk stratification is disclosed. Episodes of care are formed from medical claims data and an output process is performed. Physicians are assigned to report groups, and eligible physicians and episode assignments are determined. Condition-specific episode statistics and weighted episode statistics are calculated, from which physician efficiency scores are determined.
Abstract: A method and system for producing statistical analysis of medical care information comprises: aggregating medical care providers to a peer group level; aggregating medical care information at the peer group level and at the medical care provider level; computing a statistical analysis, such as performing Pearson's correlation analysis; and generating peer group level and medical care provider level results utilizing the computed statistical analysis.
Type:
Grant
Filed:
May 1, 2014
Date of Patent:
June 11, 2019
Assignee:
Cave Consulting Group, Inc.
Inventors:
Douglas G Cave, Yuri Alexandrian, John T Calvin, Jenine A Lara
Abstract: A method for measuring physician efficiency and patient health risk stratification is disclosed. Episodes of care are formed from medical claims data and an output process is performed. Physicians are assigned to report groups, and eligible physicians and episode assignments are determined. Condition-specific episode statistics and weighted episode statistics are calculated, from which physician efficiency scores are determined.
Abstract: A method for measuring physician efficiency and patient health risk stratification is disclosed. Episodes of care are formed from medical claims data and an output process is performed. Physicians are assigned to report groups, and eligible physicians and episode assignments are determined. Condition-specific episode statistics and weighted episode statistics are calculated, from which physician efficiency scores are determined.
Abstract: A method and system for producing statistical analysis of medical care information comprises: aggregating medical care providers; computing a statistical analysis, such as performing Pearson's correlation analysis. that includes associating a metric for each set of codes obtained from the aggregated medical care information; associating an efficiency metric from the medical care efficiency measurements for each medical care provider with that medical care provider; calculating a correlation value for each medical care provider between their efficiency metric and a metric associated with each code; and selecting a subset of codes based on the correlation values.
Type:
Grant
Filed:
September 15, 2012
Date of Patent:
June 10, 2014
Assignee:
Cave Consulting Group, Inc.
Inventors:
Douglas G Cave, Yuri Alexandrian, John T Calvin, Jenine A Lara
Abstract: A method for measuring physician efficiency and patient health risk stratification is disclosed. Episodes of care are formed from medical claims data and an output process is performed. Physicians are assigned to report groups, and eligible physicians and episode assignments are determined. Condition-specific episode statistics and weighted episode statistics are calculated, from which physician efficiency scores are determined.
Abstract: A method for measuring physician efficiency and patient health risk stratification is disclosed. Episodes of care are formed from medical claims data and an output process is performed. Physicians are assigned to report groups, and eligible physicians and episode assignments are determined. Condition-specific episode statistics and weighted episode statistics are calculated, from which physician efficiency scores are determined.
Abstract: A method and system for producing statistical analysis of medical care information comprises: aggregating medical care providers to a peer group level; aggregating medical care information at the peer group level and at the medical care provider level; computing a statistical analysis, such as performing Pearson's correlation analysis; and generating peer group level and medical care provider level results utilizing the computed statistical analysis.
Type:
Grant
Filed:
May 27, 2009
Date of Patent:
October 30, 2012
Assignee:
Cave Consulting Group, Inc.
Inventors:
Douglas G. Cave, Yuri Alexandrian, John T. Calvin, Jenine A. Lara