Doctor,Ratings,The,Nationwide, health Doctor Ratings: The Nationwide Effort
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Though youll be hard pressed to find a physicians group who approves, there is a concerted nationwide effort going on to generate consistent doctor ratings for insurance customers across the country. These rankings will be used by the insurance companies to place their network of physicians in a tier based system. The higher physicians are on the tier, the more likely it is that the insurance companies will give customers an out-of-pocket discount when they go to those offices. The lower ones may be much more expensive or dropped from the program altogether.As part of the new initiatives, insurance companies have conceded to having their ranking systems independently vetted, one small victory of physicians groups who have been almost wholly opposed to the new systems. Much of the rest of the considerations have come in the form of greater transparency of the doctor ratings system, how they arrive at their rankings, and what measures they are taking to ensure those rankings are accurate. There is also a movement to include in the system an opportunity for physicians to be able to appeal their ranking.Behind the effort are some of the biggest names in health insurance, including Cigna, General Motors, Aetna, and United Healthcare. Those representing the physicians include the American College of Surgeons and more. The movement toward using doctor ratings to help inform consumers and bring down health care costs has been in the works for some time, but this is a new step when it comes to cooperation between both sides of the fence. As one would expect, they are coming at it from different points of view. The insurance companies think the ranking system will help lower costs and improve results. The physicians think the rankings are screwed up due to faulty measurement systems and a lack of oversight.Health care experts say the trick is to find the right balance between judging bottom line results such as total costs with more delicate measurements such as the quality of the care being given. The systems being used today dont give out a lot of information when it comes to how the ranking was arrived at, leaving both physicians and customers in the dark. This lack of information has led to lawsuits and a deep rift between the insurance companies and the physicians. These new efforts are driven by the need to bridge that gap. Hopefully, the end result will be a system that is fair to both the physicians and the patients.
Doctor,Ratings,The,Nationwide,