New national standards for rating doctors to be developed

June 16, 2008

Physicians’ groups and insurers recently agreed to develop a national set of standards for measuring doctors’ performance. The agreement represents a significant step in resolving a longstanding dispute about current rating practices. Physicians charge that health plans focus too much on cost rather than quality of care and that the rankings are often inaccurate, according to The New York Times (4/2/08). Leading physician groups, including the American Medical Association, American College of Surgeons, and American College of Physicians, signed on to the agreement, along with major health insurers, such as Aetna and United Healthcare. The broad coalition endorsing the new plan also includes consumer, labor, and employer organizations.

Physicians’ groups and insurers recently agreed to develop a national set of standards for measuring doctors’ performance. The agreement represents a significant step in resolving a longstanding dispute about current rating practices. Physicians charge that health plans focus too much on cost rather than quality of care and that the rankings are often inaccurate, according to The New York Times (4/2/08). Leading physician groups, including the American Medical Association, American College of Surgeons, and American College of Physicians, signed on to the agreement, along with major health insurers, such as Aetna and United Healthcare. The broad coalition endorsing the new plan also includes consumer, labor, and employer organizations.

According to the agreement, the standards to be developed will adhere to four major criteria:

  • Measures should be meaningful to consumers and reflect the importance of patient-centered care.

  • Physicians and physician organizations should have input to these programs and the methods used to stratify performance. They should also have access to the information collected and be given notice before individual information is released.

  • Measures and methodology should be transparent, valid, accessible, and understandable by consumers, physicians and other clinicians.

  • Measures should be based on national standards, primarily standards endorsed by the National Quality Forum (NQF). Standards from other groups and organizations may be used, but they will be replaced by NQF standards when available.