Rand Corporation Study Cites Flaws in Physician Cost-of-Care Profiles by Insurers

A RAND Corporation study published in the latest issue of the New England Journal of Medicine offers the first major assessment of physician cost profiling by health insurers. The study concluded that physician evaluations based on cost factors can be misleading and may not help save money. See the abstract,”Physician Cost Profiling – Reliability and Risk of Misclassification,” at http://content.nejm.org/cgi/content/short/362/11/1014?query=TOC (Abstract only; full article requires subscription or purchase).

“The Rand Corporation study verifies the AMA’s longstanding contention that there are serious flaws in health insurer programs that attempt to rate physicians based on cost-of-care,” said AMA President J. James Rohack, MD. “The Rand study shows that physician ratings conducted by insurers can be wrong up to two-thirds of the time for some groups of physicians. Inaccurate information can erode patient confidence and trust in caring physicians, and disrupt patients’ longstanding relationships with physicians who have cared for them for years.”

The AMA has called on the insurance industry to abandon physician evaluation and ranking programs and work with physicians to create programs that “produce meaningful data for increasing the quality and efficiency of health care.”


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