We are currently working on the key topic of “Physician Profiling” and “Risk equalisation”
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12.03.2025: New Statistical Guide for Lawyers (german version, reviewed and approved by lawyers)
12.03.2025: Why risk equalisation does not work to profile patients, doctors and insurers new link, because BAG deleted the study on it’s website, as we found out by 25.06.2025: Link; the report is now again available at the BAG website here
Presentation of the problems (deutsche Version) / Statistische Selbstverteidigung
https://docfind.ch/RSAReport2024.pdf
Associated text document 2 (PCG)
Have the profiling methods (ANOVA index and REGRESSIONS index) been sufficiently validated, and if not, what are the likely implications?
An adjustment method based on pharmaceutical cost groups (PCG) is used in the cost-efficiency procedures. Are these sufficiently validated?
Planned interactive online training and discussion on the topic “WZW 2024: Arguments for a reset?” with input presentation and participation of all important stakeholders (FOPH, FMH, health economists, lawyers, health insurers) with the following questions:
“What is the legal risk of profilers when they use wrong instruments?
“To what extent could it be assumed a priori that the profiling methods meet the “realiability” requirements?”
“Which published profiling instruments have been sufficiently validated for which specialist group?”
“Where is there a need for improvement in profiling?”
https://docfind.ch/VEMSBerichtPCG.pdf
https://docfind.ch/PCG_theory.pdf
What happend so far.xlsx
Profiling risk for insurers
