Insurer Provides Physician Price, Quality Data
Aetna on Sunday posted on its Web site new information that will allow members in some areas to access price data for "30 of the most widely accessed services" for specific physicians, as well as performance data for physicians, the Washington Post reports. T
he data was previously scheduled to launch on Friday but delayed because of computer system problems. The information, including performance data for physicians in 12 specialties, became available to about 2.3 million Aetna members nationwide. According to Aetna, the Web site rates physicians on:
- Clinical quality, based on 30-day hospital readmission rates, number of complications during hospital stays, and use of recommended screenings and treatments for certain patients;
- Volume of patients, based on whether they have treated at least 20 members in the previous two years; and
- Cost efficiency, based on the total costs of tests, inpatient and outpatient care, and medications in comparison with peers.
William Fried, Aetna medical director for the mid-Atlantic region, said that the new data are "a resource to assist members in making informed health care decisions."
Most health care experts praised the new data, but some experts said that the site will not benefit a large number of individuals, in part because of relatively low enrollment in high-deductible health plans with HSAs. In addition, the new data will not help uninsured individuals or those not enrolled in Aetna health plans, some experts said.
Some experts raised concerns because Aetna's Web site says it provides "no guarantee as to the quality of the service" or the "outcome of any treatment" provided by physicians rated on the Web site.
Fried said Aetna likely will not drop physicians who fail to meet quality standards from the company network.
Sidney Wolfe, director of the Health Research Group at Public Citizen, said, "It pretty much says there's little if anything a doctor can do that would keep them from being a participating provider." Wolfe added that the new data provide "just a fraction of the information that they could be providing" (Payne, Washington Post, 8/22).