AAFP to Payers: Remember Commitment to Fairness, Transparency in Performance Measurement

The AAFP has put dozens of America's health insurance companies on notice that it expects them to abide by the principles outlined in the Patient Charter for Physician Performance Measurement, Reporting and Tiering Programs, (3-page PDF; About PDFs) which launched about 15 months ago.

The Academy's reminder to health plan executives is timely in light of the ongoing focus on value-based health care by the federal government and private payers, as well as the fact that AAFP staff continue to field calls from members about this issue.

As AAFP News Now reported last year, many of the same health plans to whom this latest message was addressed agreed slightly more than a year ago to adhere to a national set of principles for collecting and reporting physician performance measurement results to consumers. Overall, the principles were endorsed by some of America's leading business, consumer, health insurance and physician groups.

In a series of letters sent June 16, 2009, to the health plans, (2-page PDF; About PDFs) AAFP Board Chair Jim King, M.D., of Selmer, Tenn., called on each and every company to "act in accordance with AAFP policy and the patient charter in bringing fairness and transparency to your physician assessment programs."

He reiterated the Academy's position that transparency in health care cost and quality information is important and said the Academy signed the patient charter in 2008 because the document stated, in part, that

The Academy also insists that payers' physician measurement programs give FPs ample time to review their reports and that programs include a process by which physicians can ask for a review.

King pointed out that many AAFP members interpret payers' measurement activities as little more than judgments on how physicians practice medicine and rarely view them as useful tools to enhance quality improvement. He asked payers to help move physicians away from a "judgment mentality" and toward a focused effort to improve patient care.

In keeping with the Consumer-Purchaser Disclosure Project, under which the patient charter was launched, King called on the insurance companies to "use measurement systems that are fair, honest and reliable and that provide timely, actionable feedback that physicians can use to improve their practices."

King reminded payers that the Academy published the AAFP Members' Guide to Physician Assessment Programs (Members Only; 8-page PDF; About PDFs) to help physicians understand the intricacies of performance measurement and reporting and that health plans contributed to the content of that guide.

He promised that the Academy would do its part by continuing to educate family physicians about the importance of implementing continuous quality improvement activities in their practices.

The AAFP letter went to more than two dozen Blue Cross and Blue Shield health plans, Aetna Inc., Wellpoint Inc., CIGNA HealthCare, UnitedHealth Group Inc., and a host of smaller health insurance companies across the country.