UnitedHealthcare Signs NY Physician Ranking Agreement

New York Attorney General Andrew Cuomo has accomplished a clean sweep in his efforts to enlist insurance company support of a new physician ranking model that would make such programs in New York state fair and transparent. The latest development was announced in a Nov. 20 press release, in which Cuomo said that health insurance giant UnitedHealthcare, or UHC, as well as two smaller health plans, had signed legal agreements stating that they would abide by the new rules.

Just weeks ago, AAFP News Now reported that CIGNA, Aetna and Empire BlueCross BlueShield had agreed to restructure their physician ranking programs. At that time, AAFP Board Chair Rick Kellerman, M.D., Wichita, Kan., lauded Cuomo's success and reiterated that the Academy has long viewed ranking programs as unfair to physicians.

UHC is the second largest insurer in the country, providing health care coverage for more than 26 million consumers. Its UnitedHealth premium physician designation program rolls out in the New York market in December. The last two agreements announced were with Group Health Inc. and Health Insurance Plan of Greater New York.

The news affects family physicians and their patients far beyond New York, however, because UHC, along with CIGNA, Aetna, and Empire's parent company, WellPoint, have agreed to apply the principles nationwide. WellPoint is the largest insurer in the country; Aetna is the third largest.

"With these (last) agreements, doctor ranking systems in New York state are effectively reformed," said Cuomo in the release. "Every plan that had implemented, or was planning to implement, a doctor ranking program in New York state has agreed to our New York Doctor Ranking Model Code."

Terms of the official agreement (11-page PDF; About PDFs) between Cuomo's office and UHC are similar to those previously agreed upon and cover such issues as:

In the introduction to the UHC agreement, Cuomo argued that consumers need access to information about the quality and cost-efficiency of the health care they receive; however, "when the sponsor is an insurer, the profit motive may affect (the insurer's) program of physician measurement and/or reporting," he said. "This is a potential conflict of interest and, therefore, requires scrutiny, disclosure and oversight by appropriate authorities."