MMS Backs Agreement On Physician Performance

WALTHAM — The Mass. Medical Society (MMS) welcomed the release of the “Patient Charter for Physician Performance Measurement, Reporting and Tiering Programs,” an agreement unveiled in Washington recently among physician, insurer, employer, consumer, and labor organizations on principles to guide health plans in measuring physician performance and reporting the information to consumers.

“Anyone being asked to purchase health insurance with tiering of physicians should pay close attention to this agreement,” said B. Dale Magee, M.D., M.S., president of the MMS. “Tiering programs in use in Massachusetts, promoted as a cost-saving measure, are shifting costs to patients based on data and methods that do not meet these standards.

“As a result, patients are being asked to pay more, and physicians are having their reputations questioned without a basis of fact,” he continued. “Doctors from across the state are telling us that the newest rankings are extremely inaccurate and mislead their patients. We would like to see the current Group Insurance Commission tiering program suspended until it follows the same principles that are now the standard for the rest of the country.”

Groups endorsing the charter include the American Medical Assoc., American Academy of Family Physicians, American College of Physicians, AARP, America’s Health Insurance Plans, the Leapfrog Group, AFL-CIO, the National Business Coalition on Health, and major insurers Aetna, Cigna, UnitedHealth Group and WellPoint.

The gist of the agreement is that the methods should be based on standards that have been accepted by national organizations and the data should be reviewed by the doctors in advance to be sure that it actually represents patients that are theirs and conditions that they treat. At this time, the MMS has received complaints from doctors across the state that show that even these basic safeguards have not been followed.

In addition, the agreement calls for an independent oversight panel to guard against unintended consequences and to provide objective feedback regarding the effects of the program.

“According to objective measures the doctors in Massachusetts deliver care that is considerably above average in quality. Programs that judge their performance should also be of high quality. The patients and physicians of Massachusetts deserve the same standards and safeguards as those in the other 49 states,” said Magee.