Physician Rankings

It’s interesting to me that NY has gone after Aetna, Cigna, and UHG to not publish and use their physician ranking in their state.  I agree that we need information about how these ranking are created.  And, it is important that the lowest cost physician is not the highest ranked physician (necessarily).

But, it seems like a call to cooperate and drive standards that benefit patients is better than simply trying to close down the programs.

I think you need an Economic Value Added (EVA) type summary metric that aggregates a series of key data points for physicians.  In my humble opinion, those metrics need to address:

  • Percentage of their patients that are treated per national guidelines.
  • Patient satisfaction.
  • Some type of population adjusted wellness metric (i.e., adjusted to normalize across geography, age, etc.).
  • Some type of population adjusted PMPM healthcare cost for their patients (i.e., are they encouraging generics…are they using lower cost therapies when appropriate).
  • Error rate – prescribing, surgeries, tests.
  • Disease state awareness (i.e., do their patients understand their disease…this is a proxy for communication effectiveness).
  • Technology adoption – eRx, EMR, PHR.
  • Process metrics – average wait time, billing errors, HIPAA compliance.

Just some initial thoughts.  It isn’t an area I have spent a lot of time on, but it is one that is important.  Consumers would like to know how to compare physicians and choose one that meets their needs (which may vary by severity of the disease).
FYI: Here is a good blog entry by another author on this topic of metrics.

You can also look at the Physician Quality Reporting Initiative metrics.

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