Profession
Study: Physician rankings not inherently illegal
NEWS IN BRIEF — Posted Nov. 5, 2007
Health plans' physician ranking programs can withstand courtroom challenges -- as long as they are done openly, concluded a recent study from the George Washington University School of Public Health and Health Services.
The legal analysis comes amid organized medicine's increasing concerns that insurers are grading doctors' performance based on cost rather than quality.
Since Sept. 2006, physician lawsuits in Washington state and Connecticut and legal threats by New York State Attorney General Andrew M. Cuomo erupted over the programs. The claims accuse health plans of defamation and deceptive trade practices, among other things.
Researchers said lawsuits could cause problems for insurers. But they found that transparent standards for assigning doctors into so-called tiers, as well as mechanisms for identifying and correcting errors, would ensure that the networks pass legal muster. As an example, study authors pointed to the August settlement between Regence BlueShield, and the Washington State Medical Assn. and the American Medical Association/State Medical Societies Litigation Center.
The Robert Wood Johnson Foundation, which supports physician rankings, sponsored the report. It is available online (link).
Note: This item originally appeared at http://www.ama-assn.org/amednews/2007/11/05/prbf1105.htm.
