Rank Profits?
From PRing doctor-ranking companies Subimo, Best Doctors and HealthShare Technology, I figured it was only a matter of time before MCOs would use transparency altruism to mask ulterior profit motives. NY Attorney General Andrew Cuomo seems to think so, calling last week on NY health plans to halt doctor ranking programs. He also directed Empire BBCBS to disclose their criteria in doctor rankings.
Information from the press release: In an expanding industry-wide investigation, New York Attorney General Andrew M. Cuomo today issued letters to Empire Blue Cross Blue Shield, Preferred Care, and HIP Health Plan of New York/GHI requesting information on the insurers' doctor ranking programs. The Attorney General also alerted New Yorkers about potentially deceptive programs driven by financial motives and not consumers' best interests.
"Consumers need to be aware that doctor ranking programs as currently designed may steer patients to the cheapest, but not necessarily the best doctors, letting profits trump quality," said Attorney General Andrew Cuomo. "Transparency and accurate information are critical when making health care decisions and should not be clouded by conflicts of interest."
To read on, hit the "Continue Reading" link... In the three separate letters sent today, Attorney General Cuomo said:
• Requested New York City-based Empire Blue Cross Blue Shield to justify its existing ranking program known as Blue Precision, currently offered to national employers in New York City.
• Directed Rochester-based Preferred Care to halt the launch of its planned doctor ranking program and to provide details about the system.
• Warned New York City-based HIP Health Plan/GHI to refrain from launching such programs without the prior consent of the Attorney General.
In the letter to Empire Blue Cross Blue Shield, serving approximately 533,271 members across New York State, Cuomo also questioned Blue Precision's strategy to steer consumers to preferred doctors. In a publicly available presentation outlining the program, Empire describes its "sanction" model which pressures consumers to switch doctors by imposing financial penalties.
Blue Precision is expected to be operating in 22 states by 2008. The program is already available to national employers such as Wal-Mart, which has deployed the program in Florida.
"When making healthcare decisions, it is vital consumers have as much honest information and unfiltered advice as possible," said Cuomo. "Ranking systems are in their infancy. Consumers should use caution and have an open dialogue with their doctors."
In the letter to Preferred Care, serving approximately 185,188 members across New York State, Cuomo also cited concern about the insurers' "report cards," which include a measure of patient satisfaction based in large part on cost criteria.
Attorney General Cuomo is scrutinizing the emerging national trend of physician ranking programs in an effort to ensure consumers are protected. Similar letters have been sent to UnitedHealthcare, Aetna Health Plan, and Cigna in recent weeks, and discussions with these companies are ongoing.
For a complete list of county-based enrollment data, visit:
http://www.health.state.ny.us/health_care/managed_care/report/2005/2005complete.pdf
Copies of the letters are available at http://www.oag.state.ny.us..
Posted by Shawn Whalen on October 26, 2007 at 4:29 PM
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