National standards will measure physician performance

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Consumer, employer and labor organizations Tuesday announced a comprehensive national agreement with physician groups and health insurers to develop principles to guide how health plans measure doctors’ performance and report the information to consumers.

The “Patient Charter for Physician Performance Measurement, Reporting and Tiering Programs” creates a national set of principles to guide measuring and reporting to consumers about doctors’ performance.

The agreement is a step toward patient-centered health reform that gives patients reliable information that will lead to better care and help them make informed choices. Where embraced, the Patient Charter will ensure both consumers and physicians will be able to understand, trust and contribute to how health plans rate doctors’ performance, according to the Consumer-Purchaser Disclosure Project, a group of consumer, labor and employer organizations that works to ensure access to publicly reported healthcare performance information.

According to the New York Times, the collaboration represents a significant compromise between major physician groups, including the American Medical Association and U.S. health insurers, including Aetna and UnitedHealth. The pact has also been endorsed by the insurance trade group, America’s Health Insurance Plans. Insurers said they will abide by these standards and rank doctors on the basis of both the cost and quality of care they provide to their patients.

Besides agreeing to various standards for grading physicians, the insurers said they will allow independent parties to review their rankings.

There is, however, wide variation in physician performance, yet there is little information available to help consumers find and choose those who provide the best quality care. In addition, providers are paid based on the volume of services they deliver, rather than being rewarded for higher quality or improvements in care. Programs that measure and report on the performance of physicians are integral to reforming healthcare to improve health outcomes for patients, create a more efficient healthcare system, and ultimately expand access to healthcare.

“The Patient Charter is important because it both covers health plans’ activities across the entire country and gives patients and physicians in every state assurance that the reporting processes will be valid and fair,” noted Debra Ness, president of the National Partnership for Women & Families and co-chair of the CPDP.

“Physician report cards will not be based on cost alone,” said Nancy Nielsen, MD, president-elect of the American Medical Association, who described some earlier attempts by insurers as “inaccurate and misleading,” according to the NY Times.

“We think this goes a long way to resolve some of the concerns,” she noted.

The Consumer-Purchaser Disclosure Project is funded by the Robert Wood Johnson Foundation along with support from participating organizations.