MANAGEMENT OF GP & SPECIALIST COSTS

MHS PRACTICE PROFILES

DEFINITION
MHS Practice Profiles comprise a suite of quarterly retrospective comparative reports of the clinical practice of individual primary care practitioners measured against various norms and benchmarks selected by the evaluator. The direct and indirect costs generated by each practice are assessed, taking into account downstream costs such as radiology, pathology and medicine costs related to each encounter. This enables a detailed an comprehensive examination of the total costs generated by the health-seeking behaviour of the practice's patient base. These results are compared with those generated by the practitioner's peers according to geographical area, IPA (Independent Practitioner Association), medical scheme, speciality, etc.

FEATURES
A Clinical Audit Programme, based on heuristic parameters of best practice, measures patterns and trends in patient management. This service is a useful adjunct to the comparative analysis described below:

• A graphical format that is user friendly and easy to read,

• Web-enabled,

• Has the ability to analyse and evaluate the following:

• Member demographics and other factors that influence health care costs,
• Services provided by individual practitioners,
• Services prescribed by individual practitioners and performed by other, providers/institutions by means of Episode Encounter tracking.

• Performs comparisons between individual performances and a variety of comparison groups at regional or national level. Comparison groups include IPA's, other providers of the same discipline and even other providers with the same equipment,

• Enables benchmarking based on statistical norms for individual provider performance evaluation in specific areas, for example: prescription of antibiotics or the use of pathology services.