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New Analysis Underscores Legality of Physician Ranking and Public Reporting Systems When Used by Health Insurers to Improve Health Care Quality
Date:10/9/2007

a lawsuit brought by the doctors, who objected to the rating process. A July 2007 lawsuit, filed in Connecticut, by the Fairfield County Medical Association, charged several insurers with violations of state unfair trade laws because of the use of "elite" physician designation programs.

Ensuring the legality of public reporting is critical because many experts believe that the public needs significantly more information about the quality and cost of care in order to drive improvements in the quality and efficiency of health care. For instance, state and community alliances across the nation, such as those participating in the RWJF project Aligning Forces for Quality: The Regional Market Project or those working with the Department of Health and Human Services, are using quality measures and publicly reporting them in an effort to lift the quality of care. A growing number of health plans rate physicians on certain quality and efficiency measures to design insurance products that classify physicians in tiers. Additionally, plan members are given incentives to select certain high performing physicians.

The GW legal analysis concludes that transparency is critical when designing a tiering process. The analysis notes that the Washington state settlement, which established a process to include physicians in the rating process, illustrates the premium the legal system places on action that "is visible to affected populations and allows their input."

"Classifying doctors based on the quality and efficiency of their services is legal, and so is publishing information regarding health care quality," said lead author Sara Rosenbaum, JD, Hirsh Professor of Health Law and Policy and chair of the Department of Health Policy at the GW School of Public Health and Health Services. "It is undertaking these efforts in the dark that can lead to a legal backlash."

The analysis further notes that transparent standards, a transparent development process in se
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SOURCE Robert Wood Johnson Foundation; George WashingtonUniversity School
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