Health Blog : Insurers Put Money Behind Doctor Ratings: "Insurers across the country are crunching data on the performance of individual physicians, and they’re beginning to steer patients to certain docs — and away from others — based on the results, the Washington Post reports.
The industry says the effort will lead to better care at lower cost. Doctors say the ratings are often based on faulty data, and could lead doctors to cherry-pick healthy patients who are easiest to treat.
In Massachusetts, for example, six health plans pooled their data, giving them a database with 120 million claims. Some insurers in the state now charge higher co-pays for doctors who fare poorly in the analysis. A doctor whose co-pay went up $10 after he was demoted to a lower-quality tier tells the Post a patient asked sardonically: “Who did you kill?”
Doctors are rated based on quality of care and cost efficiency. Following widely accepted procedures such as getting diabetic patients to control blood sugar helps a doctor score well on quality of care; using a generic alternative to a brand-name drug wins points for cost efficiency, the Post writes."
