More Massachusetts Health Insurance Providers Ranking Doctors

More Massachusetts Health Insurance Providers Ranking Doctors in Individual Health Insurance

As the first state to enact universal health care in the country, Massachusetts is getting a lot of attention from the media, in the blogosphere, and at the Coverage Corner.

So what’s new with Massachusetts health care? More health insurance companies in the Bay State are now using a tiered doctor ranking system.

In the tiered system, doctors are rated and scored based on their ability to provide high-quality health care at a low cost.

For higher-rated doctors, patients pay lower copayments for a visit to their office. Policyholders have to pay higher copayments if the doctor is ranked lower.

Advocates of the system say it helps to bring down cost and allows patients to find the best care at the best price.

“This is a product that holds down prices,” said CEO of Tufts Health Plan, James Roosevelt Jr., of their doctor ranking program called Navigator.

Under Navigator, Tufts members’ copayments come from a three-tier system — they pay $15, $25, or $35 for a visit depending on the doctor’s rating, reported The Boston Globe.

Not everyone supports the idea.

Last month, the Massachusetts Medical Society sued the first agency to impose doctor rankings, the state-run Group Insurance Commission, which oversees the coverage for state and municipal employees.

In the lawsuit, the Medical Society claims the ranking system hurts doctors who don’t rank well, but actually do offer high-quality care for low costs.

They also argue that the way in which doctors are ranked is flawed.

But the suit doesn’t require an immediate halt to the ranking programs, so the largest insurers are now expanding plans that use the tiered rating system.

We’ll see what happens.

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