NYS creates first "doctor ranking" model in country

New York will become the model for the nation when it comes to ranking doctors. On Monday, New York State Attorney General Andrew Cuomo announced an agreement with health insurance provider Cigna to establish a model for physician-ranking programs. The announcement comes after a six-month investigation into the validity of the programs.

Doctor-ranking programs are a rapidly-growing trend within the healthcare industry. However, the programs developed by insurance providers have alarmed medical professionals because many say the rankings are based solely on cost rather than patient care.

In Rochester, the Monroe County Medical Society alerted the Attorney General’s office when Preferred Care announced plans to create a doctor ranking program for its members. Preferred Care has not released the program to its members yet and is currently designing the program to fit the new model established by the Attorney General’s office.

Under the new agreement, physician-ranking programs will:

1.)   Ensure the rankings are NOT based only on cost and will identify when cost plays a role in any ranking.

2.)   Use nationally-established standards to measure quality.

3.)   Include risk-adjustment and valid sampling in order to compare physicians to each other fairly.

4.)   Disclose to both consumers and doctors how the ranking program is designed and how doctors are ranked.

5.)   Provide a process where consumers can register complaints about the system.

6.)   Allow physicians to appeal rankings

7.)   Nominate and pay a “Rankings Examiner.” This person will be approved by the Attorney General and oversee compliance to the new rankings model, reporting to the AG’s office every six months.