Wednesday, August 31, 2005

United Healthcare's Star System Sounds Deeply Flawed to Me

United Healthcare (see previous post) has created a system of "stars" to show their clients who the "best" doctors are.

This makes a lot of sense. Who better than an insurance company to provide ratings to doctors so their clients have a better idea of which doctor to pick for their own healthcare?

Well, it sounds good anyway.

However, their star system is based on the following criteria:

  • How closely does the doctor follow scientifically valid treatments?

  • How much do the treatments that the doctor performs or recommends cost the insurance company?

  • How efficient is the doctor?

Does this sound like a complete mess?

You bet.

Doctors who shuffle patients in-and-out quickly, who recommend less expensive treatments even when more expensive tests might be helpful, and who "stick to the book" even when their own judgement tells them otherwise, these docs will do great.

But doctors who pay attention to the patients even if it takes a little longer, and who make quality judgements about the right tests and procedures for that particular patient is going to be punished in the star system.

Which doctor would you prefer?

These stars will likely tell which doctors are most profitable for United Healthcare, not which doctors are the best docs for the patient.

I hope United Healthcare patients understand that.

1 comment:

Blue Cross of California said...

It's unfortunate to hear the health care costs have raised so high and I hope something can be done to lower costs as we are in a major crisis.