business
Minnesota insurer unveils doctors' ratings over their objections
■ The state's second-largest plan is awarding stars for quality and efficiency to physicians in its network.
By Emily Berry — Posted Feb. 4, 2011
- WITH THIS STORY:
- » Related content
Minnesota physicians are fighting an effort by the state's second-largest insurer to assign stars to doctors in its network listings based on quality and efficiency scores on its new Premium Designation program.
Medica, based in Minnetonka, Minn., launched its ratings program Jan. 19 as planned, despite a request from the Minnesota Medical Assn. to delay and address what it said were errors and inaccuracies in the program. Medica has 1.6 million members in Minnesota, as well as in North Dakota, South Dakota and Wisconsin. The company said 96% of Minnesota physicians and other health care professionals are in its network.
The Medica program uses a modified version of UnitedHealthcare's Premium Designation program, which United spokesman Daryl Richard said the company uses in 138 markets. United, which is based in Minnetonka as well, doesn't sell insurance in Minnesota because state law prohibits for-profit HMOs.
Medica contracted with United to rate its network physicians, Medica spokesman Greg Bury said. He said the program began at the request of employers, and that physicians were given time to review their ratings and challenge them if they appeared inaccurate.
Minnesota HealthScores, a project of a coalition that includes the Minnesota Medical Assn., reports practices' costs and quality scores. But quality and efficiency ratings for individual physicians are new to Minnesota doctors, said Patricia Lindholm, MD, president of the Minnesota Medical Assn.
Under the Premium Designation program, physicians are awarded one star for efficiency and another for clinical quality. If there are insufficient data to reach a score, no stars are shown.
