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AMA effort aims to help improve data reports from insurers


What's the point of getting physician performance information from payers if you don't know how to read it? See who has stepped up to help you make sense of it all.

The American Medical Association (AMA) has enlisted the support of more than 60 organizations in an effort to encourage health insurers to create data reports that help you improve the care you provide.

The AMA developed the Guidelines for Reporting Physician Data with help from public and private health insurers, state and specialty medical societies, health standard organizations, and employer and consumer coalitions.

Payers, the AMA says, can take three steps to make the reports easier to understand:

  • standardize the reporting format,

  • increase transparency in how the reports are created, and,

  • provide data with more patient-level detail.

“Almost every public and private health insurer presents physicians with practice profile reports to support data-driven decision-making,” says AMA President Jeremy A. Lazarus, MD. “This feedback has been ineffective, since the complex reports vary from plan to plan and are difficult to read and interpret.”

Insurers and organizations that support the use of the guidelines include Cigna Healthcare, UnitedHealth Group, the Medical Group Management Association, the American Academy of Orthopaedic Surgeons, and the California Medical Association.

“The organizations [that] have pledged to use the AMA guidelines recognize that providing physicians with ineffective or inaccurate practice data represents a missed opportunity,” Lazarus says. “Encouraging industry-wide standardization of practice data reports will help physicians double-check the information and use accurate data as a tool to identify opportunities for practice improvement.”

In March, the AMA introduced a guide to teach doctors how to review insurer-provided practice data and use the information to improve their practice management. The Take Charge of Your Data guide is designed to help physicians understand and verify the accuracy of the profile reports insurance companies provide.

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