Method and system for producing statistical analysis of medical care information

A computer system for identifying a practice pattern associated with an efficiency of medical care providers, said computer system comprising:

• a processor capable of executing computer instructions;
• a memory coupled to the processor containing computer instructions for:
• accessing a plurality of episodes of care records, wherein each of the plurality of episodes of care records is identified by one of a plurality of episode-of-care identifiers, and includes one of a plurality of provider identifiers identifying one of a plurality of medical care providers, wherein an episode metric is defined as at least one of an average utilization per episode of care and an average cost per episode of care;
• accessing a plurality of patient treatment claim records, wherein each of the plurality of patient treatment claim records includes (i) an associated one of the episode-of-care identifiers, and (ii) at least one of a plurality of codes, each of the plurality of codes associated with at least one of a procedure and service in a medical care field associated with the plurality of medical care providers, each of the plurality of codes being assigned to one of a plurality of service categories;
• accessing, for each of the plurality of medical care providers, a provider service category episode metric for each of the service categories, the provider service category episode metric being the episode metric for the respective provider across the codes in the respective service category;
• accessing a group service category episode metric for each of the service categories, the group service category episode metric being the episode metric across the codes in the respective service category across all of the providers;
• accessing a plurality of medical care provider overall efficiency measurements each associated with one of the plurality of provider identifiers;
• displaying, to a user, a practitioner efficiency report associated with a first one of the plurality of medical care providers, wherein the practitioner efficiency report includes (i) the overall efficiency measurement associated with the first medical care provider, (ii) the provider service category episode metric of the first medical care provider for each of the service categories, (iii) the group service category episode metric for each of the service categories, and (iv) a graphical indication for at least one of the service categories that the indicated provider service category episode metric exceeds the corresponding group service category episode metric by a first threshold amount;
• receiving, from the user, a designation of one of the at least one graphically indicated service categories for a drill-down analysis;
• accessing, for each of the plurality of medical care providers, a provider code episode metric for each of the codes associated with the designated service category, the provider code episode metric being the episode metric for the respective provider for the respective code;
• accessing a group code episode metric for each of the codes associated with the designated service category, the group code episode metric being the episode metric across all providers for the respective code;
• associating, with each of the medical care providers, a code score for each of the codes associated with the designated service category, wherein the code score is based on (i) the provider code episode metric for the respective code and the respective provider relative to (ii) the group code episode metric for the respective code;
• calculating, for each of the codes associated with the designated service category, a correlation value based on a plurality of pairs of values, each pair of values corresponding to a respective one of the plurality of medical providers and comprising:
• the overall efficiency measurement associated with the respective medical care provider, and
• the code score associated with the respective code for the respective medical care provider;
• displaying, to the user, a code report for the designated service category, wherein the code report includes (i) an identifier of at least a portion of the codes in the designated service category, (ii) the correlation value corresponding to each included code, and (iii) a graphical indication of at least one of the included codes as having an associated correlation value exceeding a second threshold amount;
• receiving, from the user, a designation of a set of the included codes as the practice pattern associated with efficiency;
• and
• displaying, to the user, a practitioner target report, wherein the practitioner target report includes (i) a respective identifier of each of a subset of the plurality of medical providers, (ii) an identifier of a number of the designated codes in the practice pattern for which the provider code episode metric of the respective identified provider exceeds the group code episode metric by a third threshold amount, and (iii) for each identified provider, a link to a detail display of the provider code episode metrics of the respective identified provider for the included codes in the practice pattern.

A non-transitory recordable medium containing computer instructions for identifying a practice pattern associated with an efficiency of medical care providers, said computer instructions when executed by at least one processor cause the at least one processor to:

• access a plurality of episodes of care records, wherein each of the plurality of episodes of care records is identified by one of a plurality of episode-of-care identifiers, and includes one of a plurality of provider identifiers identifying one of a plurality of medical care providers, wherein an episode metric is defined as at least one of an average utilization per episode of care and an average cost per episode of care;
• access a plurality of patient treatment claim records, wherein each of the plurality of patient treatment claim records includes (i) an associated one of the episode-of-care identifiers, and (ii) at least one of a plurality of codes, each of the plurality of codes associated with at least one of a procedure and service in a medical care field associated with the plurality of medical care providers, each of the plurality of codes being assigned to one of a plurality of service categories;
• access, for each of the plurality of medical care providers, a provider service category episode metric for each of the service categories, the provider service category episode metric being the episode metric for the respective provider across the codes in the respective service category;
• access a group service category episode metric for each of the service categories, the group service category episode metric being the episode metric across the codes in the respective service category across all of the providers;
• access a plurality of medical care provider overall efficiency measurements each associated with one of the plurality of provider identifiers;
• display, to a user, a practitioner efficiency report associated with a first one of the plurality of medical care providers, wherein the practitioner efficiency report includes (i) the overall efficiency measurement associated with the first medical care provider, (ii) the provider service category episode metric of the first medical care provider for each of the service categories, (iii) the group service category episode metric for each of the service categories, and (iv) a graphical indication for at least one of the service categories that the indicated provider service category episode metric exceeds the corresponding group service category episode metric by a first threshold amount;
• receiving, from the user, a designation of one of the at least one graphically indicated service categories for a drill-down analysis;
• access, for each of the plurality of medical care providers, a provider code episode metric for each of the sets of related codes associated with the designated service category, the provider code episode metric being the episode metric for the respective provider for the respective code;
• accessing a group code episode metric for each of the codes associated with the designated service category, the group code episode metric being the episode metric across all providers for the respective code;
• associate, with each of the plurality of medical care providers, a code score for each of the codes associated with the designated service category, wherein the code score is based on (i) the provider code episode metric for the respective code and the respective provider relative to (ii) the group code episode metric for the respective code;
• calculate, for each of the codes associated with the designated service category, a correlation value based on a plurality of pairs of values, each pair of values corresponding to a respective one of the plurality of medical providers and comprising:
• the overall efficiency measurement associated with the respective medical care provider, and
• the codes score associated with the respective code for the respective medical care provider;
• display, to the user, a code report for the designated service category, wherein the code report includes (i) an identifier of at least a portion of the codes in the designated service category, (ii) the correlation value corresponding to each included code, and (iii) a graphical indication of at least one of the included codes as having an associated correlation value exceeding a second threshold amount;
• receive, from the user, a designation of a set of the included codes as the practice pattern associated with efficiency- and
• display, to the user, a practitioner target report, wherein the practitioner target report includes (i) a respective identifier of each of a subset of the plurality of medical providers, (ii) an identifier of a number of the designated codes in the practice pattern for which the provider code episode metric of the respective identified provider exceeds the group code episode metric by a third threshold amount, and (iii) for each identified provider, a link to a detail display of the provider code episode metrics of the respective identified provider for the included codes in the practice pattern.