Insurers in Massachusetts Expand Rating Programs Despite Opposition from Physicians

Despite opposition by the Massachusetts Medical Society (MMS), more insurers in the state are seeking to expand their physician ranking programs. In addition to the ranking program of the Group Insurance Commission (GIC), which negotiates health insurance for about 295,000 municipal and state employees and their families, two other insurers are also instituting similar plans. Tufts Health Plan, the state’s third-largest health insurer has a health plan, Navigator, which features physician rankings. Harvard Pilgrim Health Care, the state’s second largest insurer, is considering a similar plan called Independence. Last month MMS filed a lawsuit against the GIC’s ranking program on the basis that it slanders physicians who score poorly but actually provide high quality, low cost care. The lawsuit asked for broad changes to the program. If such changes are not made, MMS asked that such rankings not be used. Insurers argue such programs help keep costs at bay. GIC is currently conducting a study to determine if such programs really do steer patients to physicians providing higher quality care and reduced costs.