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Doctors Want Medica’s Ratings Program Delayed

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(credit: CBS) Edgar Linares
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By Edgar Linares, NewsRadio 830 WCCO

MINNEAPOLIS (WCCO) – Soon Minnesota doctors will be rated like hotels and restaurants.

Medica‘s Premium Designation Program is set to be released on Wednesday on Medica’s website, but doctors from the Minnesota Medical Association (MMA) want it delayed.

The program rated 9,500 Minnesota physicians in 20 different specialties with a 0- to 2-star rating. It rates doctors on quality and cost, similar to 144 other programs in other states.

“Out of the people who were scored, 70 percent got either a 1- or 2-star rating. And that’s in addition to 22 percent that didn’t have enough data to be scored,” said Dr. Charles Fazio, Medica’s chief medical officer.

Fazio says 70 percent is higher than other markets that have executed a similar program.

But the MMA doesn’t want the results released just yet. They say they want more time to review Medica’s data.

“We have concerns on how this study was conducted,” said MMA’s President Dr. Patricia Lindholm, adding that the results are premature. “How could they get all the detail on physicians on relatively limited data?”

The MMA reports they’ve thoroughly reviewed and analyzed Medica’s program and found three significant problems.

First, it lacks reliability testing to assure accuracy in physician’s results. Second, it lacks Minnesota Physicians involvement in its development. Third, it gave an inadequate timeline for physicians to review the results.

“We have serious concerns that this program will provide patients with unreliable and misleading information about costs and quality of care being provided by Minnesota physicians,” said Lindholm.

Fazio said they’ve had 150 people call Medica with questions and concerns about the data collected.

Lindholm said the report includes negative scoring for doctors who couldn’t treat patients who moved out of the area, or a negative score for a doctor who didn’t do a Pap smear screening on a patient with a hysterectomy.

“If someone brings a case like that to our attention, we look at the quality criteria that are involved,” Fazio said. “In that case the person could not have had a Pap smear, because of the past surgery, then we would make an exception.”

Lindholm said ratings were issued to Physicians in mid-December and that’s not long enough for doctors to review the information.

“And frankly, a lot of physicians didn’t notice the mailing from Medica,” said Lindholm.

Fazio added the program has been around since 2005 in other markets.

“It’s been well tested and well received,” said Fazio. “Practitioners got individual notification of this program in May of 2010, that this program was coming … what the nature of it would be … and all along we’ve been meeting with medical groups to tell them that there would be need for them to look at the information.”

Lindholm said the MMA doesn’t endorse this program but does endorse the rating of health systems.

“Such as clinics of Physicians at the group level, because that information can be used for quality improvement purposes,” said Lindholm.

Lindholm said the Minnesota Community Measurement has been ratings clinics for years. She said how Medica determined the ratings is basically a black hole to her and says Medica needs to be more transparent.

“When you rate a hotel, 1 to 4 stars at least they tell you the way they have ranked it a 1 or a 4. The amenities, the degree of service and so forth,” said Lindholm.

“Every doctor who’s been rated as part of the system has access to a website that is solely accessible to them that gives them patient-level detail about every single patient. About how those patients were assessed. About the resources that were used and whether or not we think the quality measures. And in each case, if they think there’s been an error they can come to us and we’ll evaluate and make adjustments as necessary,” said Fazio.

The Premium Designation Program will be posted on Medica’s website on Wednesday.

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