Case Studies

Attributing Episodes to Physicians

Client: Insurer, 2004

Preponderance of Episodes Found to Involve Only One Clinician

An episode of care can include a variety of health care providers: generalists, specialists and therapists, plus entities such as hospitals, surgical centers and pharmacies. Before measuring a physician’s cost efficiency, each episode must be attributed to the doctor most responsible for managing the patient’s care. Attribution can seem controversial to physicians wary of being held responsible for the actions of others. In this study, the clinician make up of several million episodes were examined to assess this concern.

Episodes may be attributed only to “managing clinicians” — those who diagnose, treat, and recommend treatment for patients. For non-Medicare patients, nearly 90% of episodes were found to involve only one managing clinician. Thus, the question of to whom an episode should be attributed is unambiguous and trivial about nine time in ten.

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