This information was developed by OptumHealth, Inc. in collaboration with Medica. The process used to determine each measure is described below. To view information about a specific measure, click on the appropriate link below.
The visits per patient measure indicates the average number of times a chiropractor treats a patient per year.
Methodology
The average number of visits per patient was calculated for each chiropractor as follows:
| Visits per Patient = | Total number of unique visits billed for all patients seen during 2016 Total number of unique patients treated during 2016 |
The number of visits is displayed in ranges, which are color-coded to highlight the different groupings. Range 1 represents visits per patient that are within the average. Range 2 shows visits per patient that are slightly above the average. Range 3 and 4 indicate visits per patient that are significantly above the average.
The ranges were identified by first calculating the mean (or average) number of visits per patient for the entire network and rounding up to the nearest whole number. Only those chiropractors who treated at least five Medica members during the 12-month period reviewed were included in the analysis. Ranges were then determined using the following methodology:
Note: The range displayed for each chiropractor reflects the average number of visits provided to all of their patients during 2016. Not every patient receives a number of visits that falls within the range displayed for their chiropractor. Depending on a specific patient's needs, the patient may have more or fewer visits than shown.
The performance standards indicators are comprised of credentialing and clinical performance measures that are compared to same-specialty practitioners. Using claims information, the chiropractor's care patterns are evaluated to determine if they are aligned with "best practices" and/or consistent with the recommendations of broadly accepted evidence-based guidelines.
Credentialing Performance Standard
Before entering the network, a chiropractor must pass a thorough a rigorous credentialing process by which specific criteria are used to assess and validate their qualifications.
The credentialing process involves an evaluation of a chiropractor's education and experience including their decision-making, practice patterns and use of current best clinical evidence in practice.
Clinical Performance Standard
Clinical performance measures are evaluated to determine if a chiropractor consistently aligns their decision-making with current evidence and community standards or "best practices." The claims data used in this process is based on all services provided by a practitioner to their patients during the 12-month period reviewed. See more.
Methodology
Chiropractors that have a minimum patient volume of members and currently meet credentialing standards are displayed with a yellow check symbol. Those that meet patient volume and credentialing standards as well as have a practice pattern that indicates performance alignment with "best practices" are displayed with a green check-plus symbol.
Note: The performance measurements are aggregate indicators of the decision-making applied by a chiropractor to their entire group of patients treated during a calendar year. It's important to know that the treatment needs of individual patients vary. As a result, treatment provided to any individual patient may exceed any or all of the set performance measure levels.
The cost measure show how chiropractors compare to one another on the cost of their care. Cost information is based on the accepted reimbursement schedule, which includes copays, deductibles and coinsurance.
Average Cost per Visit
The average cost per visit represents the average cost of care for a visit to a specific chiropractor. Costs are based on the accepted reimbursement schedule, which includes copays, deductibles and coinsurance.
Methodology
The average cost of care per visit is calculated according to the formula below:
| Average Cost per Visit = |
Total cost of care for all patients seen during 2016 Total number of unique patient visits during 2016 |
The average cost per visit information is displayed in ranges, which are color-coded to highlight the different groupings. Range 1 represents lower costs. Range 2 shows middle costs. Range 3 and 4 indicate higher costs.
The ranges were identified by first calculating the mean (or average) cost per visit for the entire network. Only those chiropractors who treated at least five Medica members during the 12-month period reviewed were included in the analysis. Ranges were then identified according to the following methodology:
Note: It is important to know that the cost information displayed for each chiropractor reflects the average cost range for care provided to all their patients during a calendar year. Depending on a patient's condition and needs, costs may vary.
*A statistical measure of the spread of the outcomes around the mean (or average)