Patent ID: 7739126

Claim:
A method implemented on a computer system of determining physician efficiency, the method comprising: obtaining medical claims data stored in a computer readable medium on the computer system; performing patient analysis using said obtained medical claims data to form episodes of care utilizing the computer system; performing output process based on performed patient analysis utilizing the computer system, the output process comprising: assigning episodes of care to physicians utilizing an assignment rule that allows assignment of an episode of care to more than one physician; and applying a first maximum duration rule to identify episodes of care for chronic conditions and a second maximum duration rule to identify episodes of care for acute conditions; assigning at least one physician to a report group utilizing the computer system, each physician assigned to no more than one report group; determining eligible physicians and episode of care assignments utilizing the computer system comprising: eliminating episode of care assignments to physicians not meeting a selected criterion for the report group of interest; calculating condition-specific episode of care statistics utilizing the computer system; calculating weighted episode of care statistics across medical conditions utilizing the computer system; and determining efficiency scores for physicians from said calculated condition-specific episode of care statistics and said weighted episode of care statistics calculated across medical conditions utilizing the computer system.