Cuomo Threatens Insurance Company Over Plans To Rank Doctors By Cost

New York Attorney General Andrew Cuomo told UnitedHealthcare to expect a lawsuit if they publish a ranking of doctors based on the cost of care to the insurer. UnitedHealthcare caused a furor in Missouri after introducing a similar ranking scheme in 2005.

Missouri doctors cited numerous objections to the pilot program, which was halted and is being redesigned. For example, most faculty members of the Washington University School of Medicine in St. Louis were initially excluded from the quality rankings because university-based care is generally more expensive. Doctors in major specialties were ranked by cost alone.

Tyler Mason, a spokesman for UnitedHealthcare, said the company had been meeting with the attorney general’s staff. He said: “We share their commitment to looking at cost and quality. That’s exactly what this is about. The assertion in the letter that sometimes higher cost equals higher quality is actually not what experts nationwide find. Sometimes lower cost means higher quality.”

Great answer, Tyler! Yes, lower cost means higher [shareholder] quality. The attorney general’s staff is rightly concerned that, “consumers may be encouraged to choose doctors because they are cheap rather than because they are good.” Consumers should be encouraged to abandon UnitedHealthcare for its over-zealous pursuit of profit. If only there were decent alternatives…

N.Y. Attorney General Objects to Insurer’s Ranking of Doctors by Cost and Quality [NYT]
(Photo: Waldo Jaquith)

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  1. banned says:

    Health Care should only be owned by non-profit organizations.

  2. ezwrites says:

    Health care costs are rising at an unsustainable rate. One reason for this is that this is one of the few markets in which consumers (patients) buy products (medical care) without any information about cost or quality. As consumer advocates we should be applauding any new information becoming available to consumers, regardless of the obvious motivations of the group releasing it.

  3. swalve says:

    Why shouldn’t the customers have the right to choose their doctor for any reason they want? Seems like the more knowledge a health care consumer has about the actual costs of their care, the better.

    What we really need is rankings of doctor quality- lawsuits, complaints, surgery revisions, etc.

  4. andrewsmash says:

    Because the most important thing to think about when choosing a doctor is the cost…yeah, right…this kind of Wal-mart mentality is what is destroying this country. The lowest price often indicates the lowest quality, and in health care, low quality now usually leads to higher costs later.

  5. a_m_m_b says:

    @swalve: amen to that. not going to hold my breath til the day tho’.

  6. Ben Popken says:

    Cost to insurer =/ cost to patient.

  7. @swalve: “What we really need is rankings of doctor quality- lawsuits, complaints, surgery revisions, etc.”

    There is such a database — the National Practitioner Data Bank, required by the 1986 Healthcare Quality Improvement Act. Unfortunately, it’s only available to doctors, hospitals, insurance companies, and the government.

    There are some problems with it (basically, it reports lawsuits, so “frivolous” suits count against a practitioner while extremely egregious cases settled out of court may not be included — and that doesn’t include cases that are simply never brought to light) but it could provide consumers with important data … if we were allowed to access it!

    [www.npdb-hipdb.hrsa.gov] The faq has a lot of info.

    One major problem with ranking hospital/doctor quality is that doctors can’t control their inputs — that is, their patients. My state, Illinois, just released a statewide report on hospital “quality” based on mortality rates. What it showed, surprise surprise, is that hospitals that serve exclusively wealthy populations in Chicago’s North Shore suburbs are EXCELLENT and have very low mortality rates, whereas hospitals that serve impoverished inner-city populations in Chicago proper have TERRIBLE mortality rates and are therefore “bad.” That doesn’t actually say a damned thing about hospital quality — it says that some hospitals serve wealthy patients who, because of their better general access to health care, are less likely to die in any given admission to the hospital. At North Shore hospitals, admission rates for elective procedures (including surgical wisdom teeth removal!) is much higher than in the inner city, and all those procedures count towards the “low” mortality rates at those hospitals.

    Many similar reports don’t even break out specialty hospitals, such as children’s hospitals or cancer centers or hospitals with level I trauma centers to whom everyone in a 200-mile radius is medivaced, which will obviously SERIOUSLY impact mortality rates!

  8. mconfoy says:

    Since United Health Care bought Mamsi, we have been hating life. They promised new providers, instead its higher costs and less providers. If I had a choice I would drop them in a heart beat. And who was that CEO doctor that was taken to court for ripping off the shareholders?

  9. Marko_Vulvic says:

    “If only there were decent alternatives…”

    There are:

    1.) Get in car. A bus, train or plane is also acceptable.

    2.) Head north between 1-4 hours.

    3.) Land in Canada.

    4.) Find attractive Canadian, Man, Woman, Gay or Straight. There are many to choose from! And your marriages will be honoured by the state.

    5.) Marry, enjoy free*, high quality health care, a non-aggresive government and higher quality of life.

    * Note, taxes will pay for your health care. This may seem strange that they are not paying for cluster bombs or chemical weapons, but you will get used to it as you will spelling Colour, Neighbour and Honour their correct way ;)

  10. Bungus Aurelius says:

    I think maybe I’ve stumbled on the wrong site? I thought this was The Consumerist? But the site is AGAINST the introduction of more transparent pricing in healthcare – even though healthcare costs are rising at (insert random high number here) times the inflation rate?

    If there were an indication that consumers were being forced to take the cheapest alternative, then it may be worth complaining. But this post only indicates that costs will no longer be hidden. New autos generally have transparent pricing, but that doesn’t mean consumers choose the cheapest option. Rather, they choose the option that is right for them – based on their needs, desires, and budget considerations. Works pretty well. What’s wrong with using pricing as ONE of the considerations in taking more control of my own health?

    Full disclosure: I am not part of and have very little interest in the healthcare industry. But I am a healthy single person with an HSA, so I’m in favor of more consumer information to aid my choices.

  11. kentuckienne says:

    This program isn’t looking at the cost of care to the consumer — United HealthCare is apparently interested in pinpointing those doctors that cost them a lot of money by, gasp, prescribing services. At least one potentially negative outcome under such a system is that doctors will be reluctant to take on older, sicker patients — who generally cost more to treat than younger, healthier ones.