New California healthcare site rates doctors

Thursday, March 30, 2017
News
Caqualityratings.org is the latest step in a long-running march toward ever-more-detailed public disclosure of information designed to convey the quality, timeliness and safety of treatments that patients receive, the San Diego Union-Tribune writes.

So far, hospitals received the bulk of this independent-assessment attention through the work of outside evaluation organizations and even the federal government. Now doctors are facing a growing consumer demand for more data to show the effectiveness of their work.

Caqualityratings.org is supported by major health insurance companies that have, for the first time, aggregated their claims information. The have worked together with a coalition of physicians and other stakeholders to create a system that begins to measure physicians in every market up and down the state.

Getting care people deserve

“This is a tool for consumers so they can make sure they’re getting the care they deserve,” Dr. Parag Agnihotri, medical director of the Sharp Rees-Stealy Medical Group, believes. Agnihotri is also chair of the physician advisory group that oversaw the creation of the star-rating system for Caqualityratings.org.  He says the information can help patients gauge health-care quality.

The star ratings are not to be seen as an objective rating system that shows whether one doctor is better than another at treating certain ailments. They focus on certain “process of care” measurements, assigning a number of stars to factors such as treating high blood pressure in diabetics and monitoring people on long-term medications.

Each doctor’s star ratings on the new website are determined in relation to the performance of other doctors working in the same specialty, so no one is getting a low number of stars on an absolute scale.

Inaccurate reviews

Doctor ratings have been a subject of some debate since websites like healthgrades.com and vitals.com were launched. They allow anyone who has received care from any particular physician to post a review under that doctor’s name. Doctors say the reviews can be inaccurate, unfair or otherwise misleading.

Caqualityratings.org is an attempt to be more objective about judging the care that physicians deliver. It lists only some 7 percent of California’s 135,375 licensed doctors at the moment, but does include 25 percent of those practicing obstetrics and gynecology, internal medicine and pediatrics. Also approximately 60 percent of cardiologists, endocrinologists and nephrologists are listed.

The California Medical Association supports the coalition’s work on the star-ratings system, but would have preferred a more complete set of information that tried to take into account patients’ compliance or lack of follow-through.

Insurance companies provided data

The information underlying the star ratings came from claims data provided by Medicare and three of the state’s largest health insurance companies: Anthem Blue Cross of California, Blue Shield of California and United Healthcare of California. Those insurance companies have worked together on the effort for nearly five years. Now that the first set of ratings has been posted, participation will be expanded to other insurance companies such as Kaiser Permanente, Aetna, Cigna and Health Net.

The California Healthcare Performance Information System is a nonprofit group that includes health-care buyers, consumers and health providers. It plans to add more categories of measurement to its initial effort in future years.