MMS Urges Insurers to Slow Down in Transparency Effort

WALTHAM — Saying that most transparency programs “fail the basic tests of accuracy, relevance, and fairness and thus threaten the health and well-being of the people of the Commonwealth,” Mass. Medical Society (MMS) President Kenneth R. Peelle, MD, called on health insurers to slow down in their race to implement transparency programs in the health care system.

Peelle’s remarks were made as part of his President’s Report to the Society’s House of Delegates, delivered on Nov. 3 at the organization’s 2006 Interim Meeting held at society headquarters in Waltham.

Peelle said “this profession embraces quality improvement, and we welcome good data that helps us improve.” But he said today’s attempts to impose transparency on our health care system, through public reporting, pay for performance, and performance measurement, are being done “too fast, too soon, with inaccurate information, and with untested tools.”

Peelle hailed the state’s new health care reform law as a “great force for change that will create a more rational, more responsible health care system,” but he added that the imposition of poorly-conducted transparency and performance measurement programs threatens to undermine the health care victory that the new law provides.

“Transparency works,” Peelle told the Society’s members, “when it is done right. It buys us the most precious commodity in the world, which is trust. It removers barriers, builds relationships, and opens new opportunities for the future. When done right, transparency will help us be better doctors, help patients make better decisions, and it will build trust among everyone who cares about our health care system.

“But right now, it’s usually not done right,” he said. “If the goal of these initiatives is to help doctors get better, then they must also provide us with the detailed, understandable, and timely information that we can use. But for now, too many health plans can’t do it, or won’t do it. That’s simply not good enough.”

Further, Peelle said that publicly rating physicians on an individual basis is far too premature and could disrupt physician-patient relationships. “Transparency at the group level is not only fairer, it actually can make a difference, a far bigger difference than reporting at the individual level.”

Peelle said the MMS will insist on accuracy, fairness, and clinical relevance in developing and implementing transparency programs, as well as insisting upon physicians becoming partners with the parties involved. Physician input to such plans is essential, he said, and physicians must have the ability to provide feedback to the health plans on the accuracy, relevance, and fairness of the data being used.

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