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Physician report cards more prevalent among MCOs, but do they work?
Insights
Payers are releasing physician report cards and will increasingly demand clinical and patient satisfaction data from hospitals. This trend is driven by market competition and a national focus on provider accountability.
Area of Science:
- Healthcare Management
- Health Policy
- Public Health
Background:
- Increasing competition among health insurance plans necessitates innovative marketing strategies.
- There is a growing national emphasis on enhancing accountability for healthcare providers.
Purpose of the Study:
- To analyze the emerging trend of payers releasing public report cards on physicians.
- To explore the future implications for hospitals regarding data transparency and managed care contracts.
Main Methods:
- Analysis of current payer practices regarding physician performance data.
- Expert interviews and market trend assessments to predict future payer demands on hospitals.
Main Results:
- At least one payer has initiated public physician report cards, with more expected.
- Payers are unlikely to develop hospital-specific report cards due to cost.
- Payers will likely mandate hospitals to disclose clinical and patient satisfaction data within managed care agreements.
Conclusions:
- The healthcare industry is moving towards greater transparency and accountability.
- Hospitals should prepare for increased scrutiny and data-sharing requirements from payers.
Abstract:
At least one payer is releasing public report cards on physicians, and others are expected to follow. Experts say it is unlikely payers will go through the expense of creating these report cards for hospitals. However, they do believe payers will increasingly ask hospitals to release their own clinical and patient satisfaction data as part of the managed care contracts. They say this is a two-part trend: First, payers are being forced by competition to find new ways to market their plans to employers and the public. Second, there is a national push to hold physicians and other providers more accountable to the public.