Insurers’ ratings for doctors draws ire
InsPals,
ITP is looking forward to its Gulf Coast excursion this Thursday. War Eagle is packing his special LSU “go” cup.
A couple quick things:
One, It is fair to say that State Farm has lost the Gulfport/Biloxi Sun Herald’s editorial board, which in an editorial that dominated yesterday’s front page, uses language not often found in what I used to call, The Press:
“According to a press release, State Farm ‘is concerned that provisions in its insurance policies are being reinterpreted after the fact to provide for coverages that were not contemplated when the policies were written.’
Bull.
State Farm is not being prudent, it is being punitive.
It is using fear to scare up a better settlement in federal court. But it is not the state’s legal environment that is becoming untenable for the insurance giant, it is State Farm’s insane contention that hurricane-force winds did not damage the property of its policyholders.”
Also yesterday, the Sun Herald ran an Anita Lee story that begins to connect the dots between State Farm’s conduct post-Katrina and after other recent disasters and about the role played by consulting giant McKinsey & Co. in the personal-lines industry’s cultural shift on claims since Hurricane Andrew in 1992. Don’t miss that one.
And since it’s my blog, I’ll point out one more thing: An AP story from a week ago about health insurers’ rating doctors according to their quality, and “not-high-quality” doctors’ attempts to push back with libel suits.
“NEW YORK (AP) — A less confident physician might have been humbled by the letters Dr. Mike Kelly received last year from two insurers.
Regence BlueShield and UnitedHealthcare informed Kelly that he failed to qualify for their respective designations as a high-quality doctor. Health insurers are increasingly rating doctors and often charge patients a lower co-payment to see those they deem exceptional providers.
‘I did doubt myself initially when I got the letters,’ said Kelly, a family physician in practice outside Tacoma, Wash., who is now suing Regence over its program. ‘But eventually I realized I didn’t do anything wrong and I felt, “how dare they do this?” I think it is all about money. They just want networks of doctors that don’t spend a lot of money.’
And insurers respond:
“That’s false, insist insurers such as UnitedHealth Group Inc., Cigna Corp., Aetna Inc. and WellPoint Inc. which all either started or expanded their physician quality ranking programs this year. They said the programs are an attempt to help employers struggling with ever-rising health care costs to ensure that their money is well spent.
‘We believe consumers should have information and access to all their doctors but we want to (give them incentives) to go to high quality providers,’ said Dr. Jeffrey Kang, senior vice president and chief medical officer at Cigna. Such products can lower health care costs by 3 percent to 5 percent, he said.”
Frankly, I’m for ratings for everyone except news reporters. But, if we’re going to rate doctors on such a delicate topic as “quality,” we have to begin to rate insurers on such a basic issue as claims performance.
Et voila! Another argument, another victory for the ITP! War Eagle, let’s go for a latte.