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Report card standards developed

Article

Washington, D.C. - Health insurers and medical groups have agreed to work together to develop national standards for rating physician performance.

Washington, D.C. - Health insurers and medical groups have agreed to work together to develop national standards for rating physician performance. Medical societies have long objected, saying rating the quality of care provided by individual doctors is unfair and misleading, however, the proliferation of divergent report cards and rating systems is generating support for more objective and transparent quality assessment.

Health insurers have been rolling out programs that award "stars" or identify "higher performance" providers. Physicians have complained that these are confusing and are joining the effort to steer measurement toward a system that evaluates practitioners based on quality of care-and not just cost.

The Patient Charter for Physician Performance Measurement project has support from: AARP; Aetna; AFL-CIO; America's Health Insurance Plans; American College of Cardiologists; American College of Surgeons; American Medical Assn.; CIGNA; General Electric; General Motors: National Business Coalition on Health; UnitedHealth Group; and WellPoint.

The standards-setting initiative aims to ensure that consumers gain information from provider rating programs that can help them make informed health care choices. Complaints from physicians and patients have prompted state regulators and investigators to consider the need for more oversight of rating activities. In addition to heading off new regulations and lawsuits, this collaborative effort expects provider quality information to be useful to patients, transparent and objective.

NATIONAL STANDARDS

Endorsing the Patient Charter gives Aetna the opportunity to advance transparency and quality-of-performance measurement, as well as to promote national consistency and standardization sought by consumers, according to Communications Director, Karin Rush-Monroe.

"Whenever possible, we use evidenced-based and externally validated measures to help ensure our programs are credible and useful to members," she says.

Aetna will adhere to the Patient Charter's criteria for Physician Performance Measurement, Reporting and Tiering.

"This includes a review by a nationally recognized, independent healthcare quality standard-setting organization of the company's programs that provide physician performance information to members," Rush-Monroe says.

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