E-Mail Bulletin #3
October 2007
More on Physician Ranking By Third-Party Payors
E-Mail Bulletin
Hello, everyone.
A couple of months ago I sent out an e-mail bulletin about a tempest that was brewing in New York over how health plans were ranking physicians and then reporting that ranking to their Members. Here's a follow-up story about a settlement that CIGNA has reached with the state. It will be interesting to see how this plays out in other states in the coming years.
The report is from the October 30, 2007 on-line excite.com.
Gil Weber
Cigna Reaches Deal on Doctors' Rankings
By VALERIE BAUMAN
ALBANY, N.Y. (AP) - Cigna Corp. (CI) (CI) agreed to provide customers with more information about how the insurer recommends doctors, state Attorney General Andrew Cuomo announced Monday.
The deal comes some six months after Cuomo announced an investigation into how insurance companies compile their doctor recommendation lists. Cuomo said then that health care companies "have an economic interest" in seeing that customers go to doctors or institutions that charge less.
But Monday's agreement did not find that Cigna was ranking doctors only by cost, and the company said it had never done so. The company said it's list of preferred doctors, always based on quality and cost, won't change because of Cuomo's agreement. Cigna will still consider both but will begin sharing more information with customers.
"Accurately measuring physician performance is an evolving and complex practice," Cuomo said in a written statement. "Today's agreement creates greater transparency and accountability."
Before the company had one list of preferred doctors. Under the new agreement, the company can now create three types of rankings; by quality, cost and a combination of both variables.
Cuomo said consumers also have an economic interest in cost efficient doctors. For example, some insurance companies offer to pay the customer's copay when they go to a less expensive doctor.
Cuomo said he expects the settlement to set a new national standard that allows customers to learn more about why their insurer is recommending a doctor.
Dr. Jeffrey Kang, chief medical officer of Cigna, said the company wants to provide meaningful information to consumers and operate with "principles of transparency, accuracy and oversight."
Cigna has millions of patients worldwide, according to its Web site. In 2006, its revenues were $16.5 billion and it had 27,100 employees.
Earlier this year, Cuomo raised questions about the information insurers use to rank specialists because it did not contain complete clinical information, which he said can skew rankings.
Under the deal, Cigna will hire a ratings examiner who will oversee the listing process, provide better notification to physicians of their rankings and add more transparency about how rankings are compiled for the consumers.
Cuomo will have approval on the ratings examiner that Cigna hires.
Major insurers nationwide either operate or are in the process of developing these programs, Cuomo said.
Aetna spokeswoman Cynthia Michener said the company would also cooperate with Cuomo in reaching a similar agreement.
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