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More Health Insurers Adopt Doctor Ranking Model

November 27, 2007
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More health insurers have adopted New York Attorney General Andrew Cuomo’s doctor ranking model, thereby agreeing to fully disclose to consumers, physicians and plan sponsors the cost and quality metrics they use to rank doctors.

Minnetonka, Minnesota-based UnitedHealthcare Services Inc., along with New York-based insurers Group Health Inc. and Health Insurance Plan of Greater New York, are the most recent insurers to agree to apply the principles from the New York attorney general’s model.

They join Cigna Healthcare, a unit of Philadelphia-based Cigna Corp.; Hartford, Connecticut.-based Aetna Inc.; and Empire Blue Cross Blue Shield, a unit of Indianapolis-based WellPoint Inc., in committing to implement the doctor ranking model.

“We are witnessing the insurance market correcting itself,” Cuomo said in a statement. “Leaders in the insurance industry are setting the standard for rating doctors by using a model that was created with the input of physicians and consumers.”

Under the model, insurers must make certain that doctors’ rankings are not based on cost alone and must disclose the extent to which cost factors into their rankings. The insurers also must rely on national standards to measure quality and cost efficiency and take several steps to ensure more accurate physician comparisons.

The doctor ranking model was a joint effort by the attorney general, the Chicago-based American Medical Association, the Medical Society of the State of New York and several consumer advocacy agencies. It is the result of Cuomo’s investigation of physician ranking programs and concern that the rankings were based on cost alone.

“Having three of the largest insurers in the country pledging to adopt the principles of the attorney general’s model … is an important victory for consumers everywhere,” Debra L. Ness, president of the National Partnership of Women and Families, said in a statement.

The agency is one of the consumer advocacy organizations that helped build the model.

Dr. Reed Tuckson, executive vice president and chief of medical affairs for UnitedHealth Group, said in a statement that UnitedHealthcare is committed to the transparent information model because physician performance assessment programs play a key role in improving health care quality and cost efficiency.

Filed by Kristin Gunderson Hunt of Business Insurance, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.

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