- Associated Press - Tuesday, January 18, 2011

MINNEAPOLIS (AP) — Minnesota’s second-largest health plan says it will launch a new system for rating thousands of doctors on quality and cost on Wednesday despite objections from the state’s main physicians group.

The Minnesota Medical Association last week asked Minnetonka-based Medica to hold off, saying the system is prone to errors and unfair, and that doctors had not been given enough time to correct errors in their ratings.

“Medica appears to be rushing to publish results that, given current science, have a strong likelihood of misclassifying physicians,” Dr. Robert Meiches, the MMA’s chief executive, wrote in a letter to the insurer last Thursday.

But Dr. Charles Fazio, Medica’s chief medical officer, told the Star Tribune for a story published Tuesday that the ratings will be posted on Medica’s website Wednesday as scheduled. The program has been in the works for more than a year.

It’s part of a growing movement to give consumers more information about their care. About 9,400 doctors will be rated using a star system to show how they perform on a variety of cost and quality measurements.

“What we’re doing is responding to a need that we hear from consumers and employers,” Fazio said.

The ratings system, known as the Premium Designation Program, is part of a national effort to show consumers how their doctors and hospitals compare. It was developed by UnitedHealthcare of Minnetonka and is used in nearly 140 other places in the country.

The ranked doctors practice in 20 specialties, including family medicine, cardiology, pediatrics, orthopedics and internal medicine. Medica analyzed claims data from 2007 to 2010 to evaluate how closely each doctor adhered to national treatment guidelines for diabetes, high cholesterol and other common conditions. Doctors get one star for meeting or exceeding national standards, and two stars if they’re also cost-efficient.

Nearly 50 percent of the Medica doctors got two stars, 20 percent one star, and only 8 percent got no stars, the lowest rating, Fazio said. The rest had too few patients in any category to qualify. In effect, he said, “70 percent of them are above average.”

Medica started notifying doctors in early December and gave them until Christmas Eve to appeal. The MMA said a number of doctors discovered errors in their evaluations.

“Among the problems reported to the MMA are errors in specialty designation, inclusion of retired physicians, quality demerits for failing to provide follow-up care to a patient that has actually moved out of state, inaccurate episode of care assignment, and incomplete data,” the association said in a statement last week.

“The data can be totally wrong,” said Dr. Patricia Lindholm, the MMA’s president and a family physician in Fergus Falls. “If a doctor starts losing patients based on a faulty score … that is a fairly serious thing,” Lindholm said.

Lindholm also said some doctors have been baffled by their scores. She said she got two stars, but didn’t know why.

She also said she’s skeptical as to whether consumers will find the ratings useful.

“I don’t think you’re going to find either good docs or bad docs through this kind of program,” Lindholm said.

Fazio acknowledged the system isn’t perfect, but said it’s a way to highlight how medical care differs from doctor to doctor in ways that affect both cost and quality. “We think it’s a pretty good system. And it’s a system that will evolve over time,” Fazio said.

Only about 150 doctors have complained about their evaluations, he said, adding that Medica will correct inaccuracies brought to its attention.

“I expected that there would be pushback, and obviously there has been,” Fazio said. “But there have also been a number of people (who) have come forward and said ‘This is great. This is exactly what we need to know.’”

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