Doctors, Regulators Raise Concerns About Health Plans’ Physician Ranking
Physician ranking programs developed by health insurers have raised concerns among state regulators and physicians, the Wall Street Journal reports.
According to health insurers, such programs seek to help members find physicians who provide the highest quality of care. However, some critics "accuse insurers of concentrating more on cost than quality when handing out the preferred labels" and maintain that the information used to rank physicians "is prone to error," the Journal reports.
In addition, physicians maintain that the "contracts they signed with the insurers to join their networks don't allow the companies to differentiate among doctors within the plans," according to the Journal (Wall Street Journal, 8/21).
New York Attorney General Andrew Cuomo (D) last week warned Aetna and Cigna that their planned physician ranking programs likely would confuse or mislead members because of problems with the information used to rank physicians. Last month, Cuomo warned UnitedHealth Group to cancel the launch of a similar program or face possible legal action (California Healthline, 8/17).
In addition, the Fairfield County Medical Association and a group of orthopedists on July 26 filed a lawsuit in Superior Court in Danbury, Conn., against Cigna and UnitedHealth over allegations related to their physician ranking programs. The lawsuit, which seeks class-action status, accuses the companies of libel, unfair trade practices and breach of contract, and seeks to require them to end the programs (Wall Street Journal, 8/21).