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Patient Charter for Physician Performance Measurement, Reporting and Tiering
In [early April], the Consumer-Purchaser Disclosure Project, and various collaborating national organizations announced that a "comprehensive national agreement" has been reached with "leading physician groups and health insurers on principles to guide how health plans measure doctors' performance and report the information to consumers."
Stakeholders signing on the initiative include AARP, AFL-CIO, the Leapfrog Group, the National Business Coalition on Health, the National Partnership for Women and Families, the Pacific Business Group on Health, the American College of Physicians, the American Academy of Family Physicians, the American Medical Association, the American College of Cardiology, the American College of Surgeons, America's Health Insurance Plans, Aetna, Cigna, UnitedHealthcare and WellPoint.
The "Patient Charter for Physician Performance Measurement, Reporting and Tiering Programs" creates a national set of principles regarding measuring doctors' performance and reporting such information to consumers. Health plans adopting the Patient Charter agree to a standard set of performance measurement principles and reporting. They also agree to have their consumer reporting assessed by an independent review organization.
Gerald Shea, Special Assistant to the President of the AFL-CIO, tells us "all of us highly value the freedom to choose our physicians. But there is only just beginning to be reliable public information to guide that choice. This can and should be remedied quickly and the agreement...is an important step towards doing so. The Patient Charter - which strikes a balance between standardization and innovation - will ensure that physician performance reporting provides patients and physicians with information they can trust and use."
Why the collaboration from stakeholders from all sides of the arena, and why now? During the past couple of years, a wide number of health plans and third party organizations have unveiled a variety of doctor and other provider rating tools on the web. The lack of standards between them, and sometimes lack of transparency in how these "transparency" tools are developed, has caused some confusion with consumers, and consternation from organized physician groups and regulators.
The Wall Street Journal, in an article...on the subject, noted "employers, insurers and patients argue that such rating information helps contain costs and improve outcomes. But doctors have chafed at being measured by what they describe as a hodgepodge of systems that lack any oversight and consistency -- and some health-care experts say they have a point. 'I think the current measures for physician care provide a very limited snapshot of what physicians do,' said Robert Berenson, a senior fellow at the Urban Institute who works on health-care issues. 'Too many eggs are put into the performance-measurement basket.' " And of course, United Healthcare and others ran into a buzz saw earlier this year with the New York Attorney General's office regarding their new doctor rating programs. Thus a set of standards would seem to serve all stakeholders well.
Physicians seem happy. Nancy Nielsen, MD, President-Elect of the American Medical Association, says "The American Medical Association applauds efforts by the Consumer-Purchaser Disclosure Project to raise the bar on the reliability and validity of information that health insurers provide to patients." Employers seem happy. Andrew Webber, president and CEO of the National Business Coalition on Health tells us "employees look to their employers to choose the best health care options on their behalf, but employers don't often have much more information about the quality of physicians in the plan than the members themselves. The Patient Charter offers consumers and purchasers confidence that plans are developing reports and physician tiering appropriately, and their doctors really are providing better, safer care. We will urge employers to include the Patient Charter in the criteria they seek when they contract with health plans." And what about those health plans? AHIP issued a statement that "the health plan community is committed to the concepts incorporated in the 'Patient Charter,' which parallels a November 2007 policy statement of its [AHIP] Board of Directors, 'Principles for Creating Effective Consumer Health Information Systems.' " Troyen Brennan, MD, Aetna's chief medical officer, states "endorsing the Patient Charter is one more opportunity for Aetna to further demonstrate its commitment to transparency and offering members reliable information." Jeff Kang, M.D., chief medical officer for CIGNA, adds "Our support for the Patient Charter also signals our continued commitment to having our processes for measuring physician performace validated by outside, independent organizations."
The Consumer-Purchaser Disclosure Project, provided the following additional information on the Charter :
- Consumer reporting must provide adequate guidance about how to use the information and any limitations in the data.
- Consumers and physicians will have input into the measurement process and how results are reported.
- Physicians must have adequate notice regarding reporting and opportunity to correct any errors.
So just who is The Consumer-Purchaser Disclosure Project? Their web site (http://healthcaredisclosure.org/) states "the Project is a collaboration of leading national and local employer, consumer, and labor organizations whose shared vision is for Americans to be able to select hospitals, physicians, and treatments based on nationally standardized measures for clinical quality, consumer experience, equity, and efficiency. The Project is funded by the Robert Wood Johnson Foundation along with support from participating organizations... The Project is an informal coalition and not incorporated as an organization. Overall management is provided by Project co-chairs, Peter Lee, Chief Executive Officer of the Pacific Business Group on Health, representing purchasers, and Debra Ness, President of the National Partnership for Women & Families, representing consumers. Strategic direction is formulated by the following broader leadership team."
The project was formed in 2001 as a result of employer organization initiatives. They state "our efforts and advocacy are focused on four priority areas:"
- Encouraging development of quality measures relevant to consumers and purchasers;
- Promoting the endorsement of a robust set of performance measures through the National Quality Forums (NQF);
- Encouraging adoption and public reporting of NQF-endorsed measures supplemented by other qualified measures to fill gaps in NQF measurement sets;
- Enhancing the availability of data to support public reporting.
For More Information:
Uniform Doctor Ratings Sought
Wall Street Journal, April 2, 2008 (Subscription Required)
http://online.wsj.com/article/SB120706217232480477.html
Consumers, Health Care Purchasers, Physicians, and Health Insurers Announce Agreement on Principles to Guide Physician Performance Reporting
Consumer-Purchaser Disclosure Project Press Release, April 1, 2008
http://healthcaredisclosure.org/docs/files/PatientCharterDisclosureRelease040108.pdf
AHIP Endorses "Patient Charter" to Guide Physician Performance Measurement, Reporting
AHIP Press Release, April 1, 2008
http://www.ahip.org/content/pressrelease.aspx?docid=22829
Aetna Supports Patient Charter For Physician Performance Measurement, Reporting And Tiering Programs
Aetna Press Release, April 1, 2008
http://www.aetna.com/news/2008/0401a.htm
CIGNA Joins Leading Consumer, Employer and Labor Organizations in Push for Physician Performance Measurement Standards; Endorses National 'Patient Charter'
CIGNA Press Release, April 1, 2008
http://newsroom.cigna.com/article_display.cfm?article_id=876
