The Use of Individual Provider Performance Reports by US Hospitals

In the Journal of Hospital Medicine, Joshua Rolnick and Kira Ryskina analyze trends in how hospitals use the electronic health record to track and provide feedback on provider performance. The authors use data from a nationally representative survey of US hospitals from 2013 to 2015 to identify hospitals that have used electronic data to create individual provider performance profiles (IPPs). They model how the odds of IPP use differ as a function of hospital characteristics, including ownership (non-profit, for-profit, or government), geographic region, teaching versus nonteaching status, size, expenditures per bed, proportion of patient days covered by Medicaid, and risk-sharing models of reimbursement.

The authors find a large and increasing proportion of US hospitals reporting use of electronic data to measure individual provider performance. In 2015, 65.8% of the 2334 respondents used performance profiles, whereas 59.3% of the 2077 respondents used them in 2013. IPP use was associated with non-profit status versus for-profit, large hospital size versus small size, having higher expenditures, and participation in a health maintenance organization or bundled payment program. While a majority of hospitals now use IPPs, more than a third do not; the authors conclude that those hospitals may be less well positioned to adapt to value-based payment reforms.