Physician Ranking Systems Are Not Based Solely On Costs

Armen Hareyan's picture

Physician Ranking Systems

New York state lawmakers, led by Attorney General Andrew Cuomo (D), onMonday said they would pass a law that ensures health insurers usequality-of-care measures and not only cost in their physician rankingsystems, the AP/Albany Times Union reports. Cuomo developed a model code for physician ranking systems, and six insurers, including UnitedHealth Group, Aetna, Cigna and Empire Blue Cross Blue Shield, have agreed to adopt it. Four of the insurers said they would apply the code to their ranking systems nationwide.


Underthe code, insurers must disclose their ranking criteria to physiciansand consumers and must base their rankings on established nationalstandards. In addition, insurers must retain a monitor to overseecompliance with the agreement. Cuomo's effort received support fromleaders of physician and consumer groups.

Cuomo began thecampaign to create standards for physician ranking systems because "hewas concerned insurers might rate a doctor's quality baseddisproportionately on the insurance company's economic interests,"according to the AP/Times Union. "It is imperative thatNew Yorkers aren't steered to certain preferred physicians based solelyon cost but instead have access to clear and meaningful measurements ofquality of care to help them make well-informed decisions," Cuomo saidon Monday.

American Medical AssociationPresident-Elect Nancy Nielsen said, "Attorney General Cuomo is to becredited for persuading many of the nation's largest health insurers toacknowledge the risks of physician profiling" (Matthews, AP/Albany Times Union, 11/27).

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