PHYSICIAN CONSORTIUM

The Provider Resources, Inc. (PRI) Physician Consortium for Clinical Integrity is comprised of over 228 board certified physicians and allied health providers with evidence-based medicine expertise in over 77 specialty and subspecialties. These clinical experts support programs across all PRI divisions with committee oversight under the leadership of Chief Medical Officer, Dennis Agostini, DO, Consortium Lead, Reed Gelzer, MD, and Medical Director, George Costantino, MD.

Physician Consortium Mission

The Physician Consortium is committed to assuring the clinical integrity of our healthcare system. By applying multidisciplinary physician expertise to support the influence of care quality, safety and improvement as well as program safeguard vigilance, this mission is accomplished through assiduous statistical analysis, rigorous medical record review, and thought leadership. The Physician Consortium affords the opportunity to create tools, strategies and support systems for practitioners, in addition to providing state-of-the-art education programs and innovative policy and regulatory guidance.

Physician Consortium Purpose

The Physician Consortium was created as a vehicle to provide a fair and balanced approach to healthcare integrity, quality, policy, regulatory, and education initiatives with the following objectives:

Currently, the Consortium members provide Clinical Peer Review for local, state, and federal contract within the Program Integrity Division. They offer evidence-based medicine expertise to review care of beneficiaries across multiple payers – such as Medicare, Medicaid, Workers’ Compensation, and Veterans Administration. Within the Healthcare Quality & Disparities Division, the Consortium providers offer clinical experience and insight regarding technologies and interventions which have impact on the healthcare system or cost to the U.S. Government. The Physician Consortium opinions support current Comparative Effectiveness Research (CER) processes that provide the building blocks to support evidence-based practice and decision making. They address questions about treatments or diagnostic tests to help clinicians and patients choose the best options and help healthcare policy makers formulate decisions about healthcare services and quality improvement. An important element of the Physician Consortium opinion focuses on the systematic identification of research gaps and the recommendation of studies and approaches to fill those gaps.

PHYSICIAN CONSORTIUM SPECIALTIES AND SUBSPECIALTIES