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NY and Physician Ranking: Let the Games Begin

by Fred Fortin

Given my recent post on the legal challenges that may await health plans that tie compensation to quality indicators, I forgot to mention one of the big ones as exemplified in the story summarized below. It seems that the New York Attorney General is now in the business of ranking physicians.

In the past few months, New York’s attorney general’s office has requested information from several health insurers, including Cigna, Aetna Inc. and UnitedHealth Group Inc., about how they rank doctors under their programs. Mr. Cuomo’s office has expressed concern that the programs carry “significant risk of causing consumer confusion, if not deception.” . . . His office had sent letters to Cigna, Aetna, UnitedHealth, Empire Blue Cross Blue Shield and other health plans asking them to justify their methodologies and warning some not to launch the programs in New York without approval. . .

He later announced a first-of-its-kind agreement with Cigna Corp. that he says may help to establish an industry standard for the doctor-rating systems that health insurers increasingly use to guide consumers.

Medical groups and regulators in some states say that many of these programs are confusing and may steer patients to the cheapest, rather than best, doctors. Already the practice has sparked a lawsuit by some Connecticut doctors asking a state Superior Court judge to halt UnitedHealth’s and Cigna’s rating systems, citing breach of contract and unfair trade practices, among other things.

So let the political games begin.