Minnesota doctors urge Medica to delay physician rating program

The Minnesota Medical Association has asked Medica to delay the January 19 release of its individual physician rating program, known as the Premium Designation Program.

"We have serious concerns that this program will provide patients with unreliable and misleading information about the cost and quality of care being provided by Minnesota physicians," said MMA President Patricia Lindholm, MD.

According to the MMA, the new program lacks reliable testing procedures, did not include Minnesota physicians in its development, and offers an inadequate timeline for physicians to review the results and underlying data.

The MMA cited these examples of errors in the program:

• Medica penalized a physician for failing to order a Pap test on a patient who had had a total hysterectomy nine years prior.
• Medica faulted a physician for giving non-steroidal, anti-inflammatory drugs to a patient with hypertension; the patient's blood pressure had reportedly been normal for years.
• Medica penalized a physician for failing to do a strep test when the test had reportedly been done.

"Errors such as these and others including errors in specialty designation and inclusions of retired physicians demonstrate that this program is not ready for prime time," Lindholm said. "Releasing inaccurate information about individual doctors will harm reputations and mislead patients looking for help finding quality care."

The MMA said it supports performance measurement of doctors and clinics when "such analyses are valid, reliable and useful," but this program is inconsistent with Minnesota's community standards of measuring clinic performance.

A review of a similar physician rating program in Massachusetts reportedly found that 22 percent of the physicians were likely to be misclassified. The RAND review concluded, in the March 18, 2010, issue of the New England Journal of Medicine, that current methods for assessing physician performance may produce misleading results.

The Medica Premium Designation Program is a United Healthcare-developed program. Physician results are based on a rating of 0-2 stars, with two stars used if a physician meets the quality and cost efficiency criteria, one star used if a physician meets only the quality criteria and no stars if the physician fails to meet the quality criteria.