AMA: Physician Ranking Programs Must Put Quality First

Main Category: Primary Care / General Practice
Also Included In: Public Health
Article Date: 31 Oct 2007 - 13:00 PDT

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"On behalf of the American Medical Association, I would like to commend New York Attorney General Cuomo for his groundbreaking agreement with CIGNA. Physicians greatly appreciate your leadership and your commitment to our shared goal of enhancing the quality of care and ensuring patients are provided with reliable information that is meaningful to them.

"The AMA also commends CIGNA for leading the industry by renouncing physician evaluations and rankings based solely on economic factors, and agreeing to a balanced approach that acknowledges physician ratings have a risk of error and should not be the sole basis for selecting a physician.

"The AMA expects this agreement will influence other states to implement careful and independent oversight and evaluation of physician performance measurement projects to assess their integrity and fairness.

"This agreement is important because it establishes a process that seeks to guard against some of the risks inherent in physician performance programs run by health insurers. A lack of scrutiny has allowed health insurers to unfairly evaluate a physician's individual work using an insufficient number of patient cases, questionable quality measures and poor adjustments for risk. Consequently, patients could be presented with skewed and inaccurate information on caring physicians who were unfairly evaluated.

"Patients should always be able to trust that the information they receive on physicians is valid and reliable, but the integrity of this information can be undermined by a health insurer's corporate profit motive. This conflict of interest can erode confidence and trust in physicians, and disrupt patient's longstanding relationships with physicians who know them and have cared for them for years.

"Given the potential risks to patients, the AMA believes state lawmakers and regulators have an important public responsibility to establish proper oversight of health insurers to ensure that physician performance measurement is used primarily to enhance the quality of care. "Attorney General Cuomo is the first state official to establish fundamental protections that strike a fair balance among the interests of patients, doctors, and insurers - while also providing room for further evolution in the future. We congratulate him for addressing the complex challenges and evolving needs of physician performance measurement with insightful procedures and requirements.

"As a New Yorker, I am proud to be here today with the New York Attorney General's office. I urge him to continue his efforts to protect the patient-physicians relationship, and I offer the AMA's assistance in ensuring his unprecedented agreement is successfully implemented."

http://www.ama-assn.org