Patent ID: 8630871

Claim:
A computer-implemented method comprising: receiving, at a computer system having a processor and memory components, a plurality of claim records representing services provided to one or more patients; grouping, with the processor, the claim records into claim groups, each claim group including claim records representing care provided by one or more providers to one of the patients; assigning, with the processor, each claim group to a provider; assessing, with the processor, claim records in each claim group using treatment guidelines for a particular disease or condition associated with the claim group; generating a compliance score for the claim group, wherein the compliance score indicates an extent to which the claim records in the claim group match the treatment guidelines; aggregating, with the processor, compliance scores for each claim group to generate a raw aggregate compliance score for each provider; normalizing, with the processor, the raw aggregate compliance scores to generate a normalized aggregate compliance score for each provider; and generating, with the processor, a provider quality rating for each provider using the normalized aggregate compliance score.