Los Angeles Times Urges Physician Group Changes

In response to the demise of five "major" physicians groups in the past two months, a Los Angeles Times editorial urges Department of Managed Health Care Director Daniel Zingale to make "substantive changes" in the way physician groups are paid and organized. The Times suggests Zingale follow a "sensible if long-ignored" monitoring plan proposed in 1998 by a state task force chaired by Stanford University professor and "managed care pioneer" Alain Enthoven. The task force proposal called for the state to "closely monitor the fiscal solvency of physician groups, weeding out the weaker ones to ensure that the stronger ones survived." The editorial suggests that Zingale also consider a second task force recommendation "that many doctors have been slower to embrace" -- requiring all state health plans "to disclose extensive information on the medical success rates, or outcomes, of physicians." This information is "too often kept secret," the Times laments, and exposing "solid data on medical quality" would enable the state, physician groups and HMOs to "award bonuses not just for saving money but for saving and bettering lives." The piece cites the example of Kaiser Permanente, which has offered "bonuses to employees if the department in which they work shows improved medical results or offers service that is rated highly by patients." The editorial concludes that exposing quality data would allow businesses to make "better choices for employee health care" and would allow individuals to make "informed decisions that take into account both quality and price" (Los Angeles Times, 12/1).