Errors force BCBS of TN to postpone doctor ratings

Dogged by complaints that its data was inaccurate, BlueCross BlueShield of Tennessee has put its planned doctor rating program on hold. During a 60-day review period BCBS gave doctors, the physicians came back with many complaints about inaccuracies. For example, the data sometimes suggested that they didn't perform certain tests, even though the doctors had such tests documented in their own records. In such cases, the health plan has been allowing doctors to submit their records to supplement the claims data it uses for ratings. After it responds to doctors' questions and concerns, BCBS of Tennessee still expects to publish physician quality and cost data, which will be available to privately-insured members through a secure web connection.

Unlike its health plan brethren in New York, BCBS of Tennessee doesn't have to live up to any regulatory or legislative standards in compiling the data. It will be interesting to see whether this furor raises calls to create standards such as those proposed by New York Attorney General Andrew Cuomo and the New York state legislature. My bet is that such state-driven guidelines are likely to pop up in other states soon, and I'm betting Tennessee will be no exception.

To learn more about this controversy:
- read this article from The Tennessean

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