Physician ratings laws are inevitable

Physician ratings laws are inevitable

Nearly every day, it seems, another health plan introduces a physician rating or ranking system--and doctors get angry. While the nuances of the debate vary from plan to plan and state to state, generally speaking, physicians seem to feel that the ranking systems aren't fair.

Regardless of the ratings scheme, there's usually a few common themes to the complaints. When health plans are doing the ranking, physicians worry that the plans will steer patients to practitioners with the lowest prices regardless of quality. When consumers are commenting, they fear unfairly scathing reviews that don't really address their performance. And in both cases, physicians don't like the idea that they might not get to appeal unfair judgments.

For years, medical associations didn't get much of a hearing on this issue...and doctors grew more and more frustrated by the day.

But lately, state officials have begun to take their concerns to heart. In New York, in fact, legislators have begun considering a bill [1] which would impose uniform physician ranking standards on health plans. The bill would transform the Attorney General Andrew Cuomo's Doctor Ranking Model Code from a set of (strongly recommended) standards into law.

At this point, it's not clear whether AG Cuomo and the legislature will make this happen this time around. What does seem clear, however, is that this is just the first of what is likely to be a long series of physician-ranking regulations and legislation.

After all, it just makes sense. While health plans and employers have a legitimate interest in encouraging transparency and quality, unchecked, poorly designed ratings systems can do a lot of damage to a physician--while failing to meet their stated goals of promoting quality and fair pricing.

During the next several months, mind you, I doubt a lot will get done on this front, given that such regs are just gathering steam. But when the dust has settled on the presidential election, have no doubt that physician rating rules are on the way. I'd bet my hat on it. - Anne [2]

P.S. I'm proud to announce that we'll soon be expanding our free services to you.  If you're particularly interested in healthcare finance issues, we encourage you to sign up for our new weekly bulletin--FierceHealthFinance--focused directly on the business issues faced by healthcare CFOs and financial managers. Sign up at www.fiercehealthfinance.com [3]--your free subscription will start February 13.