Return to Previous Page

Academy's Letter to UnitedHealthcare Asks for Program Review

By Sheri Porter
4/12/2005

The AAFP has asked UnitedHealthcare to suspend implementation of its UnitedHealth PerformanceSM Program until serious flaws can be addressed.

In previous AAFP news coverage, "Academy Blasts Insurer's Performance Program," Academy leaders called the program a tiered network benefit plan that was unfair to physicians and disruptive to continuity of care.

The April 5 letter to UHC Chair and CEO William McGuire, M.D., said the Academy favors nationally agreed-upon quality performance measures that will improve patient care.

"However, the UnitedHealth Performance Program falls short of being a viable performance measurement program," wrote AAFP Board Chair Michael Fleming, M.D., of Shreveport, La.

Fleming said the program "appears to be less about providing legitimate information to inform patient decision-making and more about directing patients to low-cost physicians using questionable information and methodology." He said the program is "misleading and confusing" to patients and that a patient's usual source of care -- his or her medical home -- may be falsely presented by the UHC program as "providing inferior care."

"We believe that there is a more effective way to recognize high-quality, cost-effective health care," concluded Fleming.