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Publications and Studies

Revisting Quality Implications of Efficiency-Based Clinician Profiling
In an expanded and enhanced re-examination of the 2004 study (see below), evidence-based medicine is once again found to be poorly correlated with episodic cost efficiency.
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Authors: Mark Rattray MD, James Andrianos MBA, and Dorothy Stam BA.


“Quality Implications of Efficiency-Based Clinician Profiling”
Efforts to steer patients to cost-efficient clinicians may result in reductions in recommended care. Short term savings may be offset by acute care costs longer term, along with degradations in quality. Plans and large employers should insist on measuring both efficiency and quality when considering such products.
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Authors: Mark Rattray MD, James Andrianos MBA, and Dorothy Stam BA.


“Study of Professional Episode Attribution Thresholds”
Physicians are understandably wary of being deemed the “responsible clinician” for an episode of care — which by definition may include a variety of health providers. In this study, nearly 90% of episodes for non-Medicare patients 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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Authors: James Andrianos MBA and Dorothy
Stam BA.


“Using Cost Accounting Data to Improve Clinical Value”
In the early 1990s, a hospital-physician organization pioneered patient-centered cost reporting by capturing both facility and professional services. This work included experimental forays into condition-related utilization over time — a precursor to the so-called “episode” of care.
View full article online
Authors: James Andrianos MBA and Mark Dykan RN. Healthcare Financial Management. Healthcare Financial Management Association. May 1996.


“A Cost Analysis of Delayed Graft Function”
Authors: Thomas Hefty MD, Mark Dykan RN, and James Andrianos MBA. Poster Session, Western Section, American Urological Association, Scottsdale AZ. Nov 1995.




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