Last Updated: 2007-11-13 16:25:23 -0400 (Reuters Health)
NEW YORK (Reuters) – U.S. health insurer Aetna Inc agreed to make changes to its doctor-ranking system nationwide following a probe into such programs by the New York State attorney general.
Aetna is the second insurer to adopt a model for physician ranking programs and the first to apply it nationally, New York State Attorney General Andrew Cuomo’s office said in a statement on Tuesday.
The model compels insurers to disclose to consumers and physicians all aspects of their ranking system. The insurer must also retain a monitor to oversee compliance and to report to the attorney general every six months, the statement said.
Aetna’s existing program, known as Aetna Aexcel, designates physicians in 12 categories, using certain clinical quality and cost efficiency measures, Cuomo’s office said.
Aetna did not tell its consumers how much of the evaluation process was based on cost efficiency and how much on quality measures, but will do so now, it said.
" Aetna is committed to transparency of information to physicians, members and employers who purchase health plans," Troyen Brennan, Aetna’s chief medical officer, said in a statement.
Cuomo had earlier warned that doctor-ranking programs may steer patients toward low-cost physicians at the expense of quality.
His office had sent letters to Aetna, Cigna Corp and UnitedHealth Group Inc, warning them that their physician-ranking programs were likely to confuse consumers.
Letters were also sent to Empire Blue Cross Blue Shield, a state health plan under the umbrella of WellPoint Inc, and Preferred Care and HIP Health Plan/GHI, requesting information on their programs.
Last month, Cigna reached a similar deal with Cuomo, agreeing to make certain changes to its doctor-ranking system.
Aetna’s shares were off 27 cents, or 0.5 percent, at $53.65 during afternoon trading on the New York Stock Exchange.
