BlueCross to post doctor costs, ratings

Starting in April, BlueCross BlueShield of Tennessee’s commercial customers will get access to ratings and prices for about 10,000 physicians across the state.

BlueCross, the state’s biggest health insurer, has worked with physicians here to address concerns about the information to be posted on the insurer’s Web site, said Allen Naidoo, director of medical informatics at BlueCross. The information will include costs of specific procedures and evaluations of a doctor’s use of screening tests, he said.

“We have really partnered with doctors from across the state ... to design the program so that Tennesseans will make better-informed health care choices,” he said. “We are not recommending one physician over another. We are simply providing factual information.”

Dr. Collin Cherry, a primary care physician in Chattanooga, said he is not satisfied with BlueCross’ efforts to reach out to physicians in this process, and he expects many doctors here to have problems with the ratings.

“Is it going to be met with resistance? Yeah,” Dr. Cherry said. “I guess we’ll just have to wait and see what it looks like. I’ll very much look forward to picking it apart.”

Russ Miller, Tennessee Medical Association senior vice president, said his organization worked with BlueCross to gain insight from doctors and identify indicators that accurately would reflect quality of care.

Physician ratings have become more common among insurers in recent years, particularly in light of the movement toward consumer-directed health care plans that encourage members to make cost-conscious health care decisions, officials said.

The trend has provoked criticism that insurers are looking to direct members to whatever services will cost the least, said Rae Bond, executive director of the Chattanooga and Hamilton County Medical Society.

“You can’t rate something as complex as medical care simply on what a medical procedure costs,” she said.

BlueCross officials said the publication of doctor costs and ratings is a response to requests from consumers and employer organizations.

With more information, consumers can make better choices about their care, said Jerry Burgess, president and chief executive officer of the Knoxville-based HealthCare 21 Business Coalition. The group has met with BlueCross officials many times over the past couple of years, he said.

“We urged them to give to consumers more information,” Mr. Burgess said.

Dr. Colleen Schmitt, gastroenterologist with the Galen Medical Group in Chattanooga, said quality indicators can be valuable to patients as long as the information is presented accurately and fairly.

“We are in favor of demonstrating that we provide high-quality care. We want to ensure that the methods that are used are valid, patient centered and, of course, evidence based,” she said.

A state law enacted last year requires that physicians be able to access the data 60 days before it is made public, and doctors will have avenues to challenge results before the rankings are opened to consumers, BlueCross officials said.

Chattanooga gynecologist Phyllis Miller said she is worried that appealing contested rankings on the site may end up being difficult.

Dr. Miller, a past president of the Tennessee Medical Association and the local medical society, said that about six months ago insurance company United HealthCare released physician rankings, and she spent hours resending information and reviewing charts to get an inaccurate rating changed.

“I won’t ever do it again. I’ll just go with whatever they tell me my rating is because it’s simply not worth the time and energy to do it,” she said.

Doctors here also were concerned that the information posted might be misleading.

For example, Dr. Schmitt said, evaluations based on the use of blood screenings unfairly could reflect badly on a physician if a patient is not compliant with doctors’ recommendations and doesn’t get an ordered test.