Empire BCBS Agrees To Establish Physician Ranking System

Main Category: Health Insurance / Medical Insurance
Also Included In: Primary Care / General Practice
Article Date: 16 Nov 2007 - 11:00 PDT

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Empire Blue Cross Blue Shield will create a physician ranking system in New York that provides information about how cost-efficiency and skill contribute to its selection of "preferred" providers, New York Attorney General Andrew Cuomo (D) said Wednesday, AP/Long Island Newsday reports.

Empire plans to launch a physician ranking system in the state next year. The company is the third insurer in the past two months, along with Cigna and Aetna, that has agreed to guidelines for ranking systems developed as a collaborative effort by Cuomo's office, the American Medical Association, the Medical Society of the State of New York and consumer advocacy groups (Bauman, AP/Long Island Newsday, 11/14).

Cuomo had expressed concern that ratings systems based solely or disproportionately on cost could confuse or potentially deceive consumers trying to select a physician. Cuomo in a statement said, "Our agreement will encourage the nation's leading insurers to line up to adopt similar principles of accuracy, transparency and oversight, establishing our model as the norm within the industry."

Under the guidelines, insurers must use nationally recognized standards to measure quality of care, and they must disclose to consumers how the program is designed and criteria used to rank physicians (AP/Houston Chronicle, 11/14). In addition, Empire will hire an oversight monitor, known as a ratings examiner, who will evaluate the insurer's compliance with the agreement and report to Cuomo biannually. Cuomo also will meet with Empire twice per year to review information compiled by the company (AP/Long Island Newsday, 11/14).

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