Minnesota health plan releases doctor ratings despite opposition

Medica has begun publicly rating thousands of doctors on its website--despite calls from physicians to delay the online ranking system.

Minnesota's second-largest insurer is using a "star system" to indicate which doctors meet certain thresholds for quality and cost-efficiency in 20 medical specialties. Medica used three years' of patient claims data to determine which doctors adhere to national treatment guidelines, and which have higher than average costs, reports the Star Tribune.

Doctors are first evaluated in terms of quality. That information is gathered by looking at claims data. Then, they're evaluated for efficiency, or how well they use the resources at their disposal. If a physician receives two stars, they meet both the quality and efficiency benchmarks. If they're given one star, they've only met the quality criteria. No star next to their name means they either weren't rated or didn't meet the criteria all together, according to WDIO.

The Minnesota Medical Association (MMA) asked Medica to delay publication, saying the system is prone to errors and unfair to doctors. But Medica officials have been informing doctors about the program for nearly a year, and doctors can report errors and ask for reconsideration of their cost and quality scores at anytime. Of the 150 errors reported by doctors so far, about 80 percent have involved the physician's address and whether the doctor is categorized as a family medicine or internal medicine doctor, notes the Pioneer Press.

Dr. Jim Guyn, Medica's medical director, called MMA's request discouraging. "They talk a lot about wanting quality and transparency in cost and quality data," he told the Pioneer Press. "But then when we give them this type of program they're unhappy with it."

To learn more:
- read the Star Tribune article
- see the WDIO story
- check out the Pioneer Press piece

Related Articles:
Physician ratings laws are inevitable
 
Guest Commentary: Are physician rating systems fair?
 
Doctors slam Blue Shield's physician rating system: 'Serious and disturbing flaws'
 
BCBS partners with Zagat to expand physician ratings

Suggested Articles

The Centers for Medicare & Medicaid Services released the MA plan star ratings for the 2020 plan year on Friday.

A New Orleans-based genetic testing company will pay $42.6 million to resolve False Claims Act and kickback allegations.

A three-judge appellate panel didn't appear convinced that Medicaid work requirements meet the law's objectives of providing coverage.