December 8, 2006
Statement attributed to:
William G. Plested, MD
AMA President
"The American Medical Association (AMA) is pleased with recent developments in the first physician lawsuit against a health insurer's use of unproven economic criteria to compare physician performance.
"Yesterday's decision by Regence BlueShield to abandon its flawed Select Network is a good first step toward eliminating arbitrary measures that do not accurately reflect physician quality.
"Patients' choice of a physician must not be influenced by a health insurer's mistaken assumption that low cost is the only acceptable measure of high quality care.
"Regence's decision to drop its Select Network comes less than a week after the AMA Litigation Center, a coalition between the AMA and state medical societies, joined the Washington State Medical Association and six physicians in their suit against the insurer.
"The case is the first test of a new AMA directive that was adopted last month by the nation's physicians to counter health insurers' use of unproven efficiency criteria to compare physician performance. Under the new directive, the AMA will work to:
- induce health plans to disclose criteria used to compare the performance of physicians;
- ensure physician comparisons are not inappropriately driven by economic criteria;
- prevent unfair health insurer restrictions from jeopardizing patients’ access to health care; and;
- explore legal action designed to address questionable economic profiling of physicians.
"The AMA is committed to the goal of empowering patients to become more prudent purchasers of health care. This goal can be achieved only if health insurers work with physicians to ensure the appropriate development and use of performance standards."
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For additional information, please contact:
Robert J. Mills
AMA Media Relations
(312) 464-5970
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