Texas Blues plan suspends rating system -- for now

The plan reacted to physician pressure in suspending an effort to post doctor cost and quality ratings online. But that effort still might come back.

By Jonathan G. Bethely, AMNews staff. Jan. 15, 2007.

BlueCross BlueShield of Texas says it was just doing what employers and other constituents wanted when it created a new doctor-rating system called BlueCompare. But the health plan postponed the program's January launch after complaints came pouring into the Texas Medical Assn. about the method used to rank physicians.

The Blues plan is leaving open the possibility of instituting BlueCompare in the future, though it has given no timeline for when that might happen.

The plan says the online tool is a way for consumers to obtain cost and performance information for nearly 38,000 physicians in Texas. At issue is the fairness behind ranking physicians using health care bills and insurance claims, instead of using the patient's actual medical records to evaluate the quality of care that physicians provide.

"Because they feel they're under pressure, they released a program just to give them more clout with their businesses," said Ladon W. Homer, MD, president of the Texas Medical Assn. "This is nothing more than a marketing tactic on their part."

Similar arguments have been made against ratings systems by other state plans, including systems that would let patients pay less out of pocket to see highly rated physicians. In the Texas Blues' case, no special tiered network was set up to separate higher-rated physicians from lower-rated doctors.

BlueCompare's rating system would break physicians into three categories: more, average or less affordable. The system also would used colored ribbons to rank physicians on how well they practice "evidence-based medicine." Those deemed to perform well under that heading would have a blue ribbon next to their names. Those considered average would have a light-blue ribbon. Those considered less than average, or for whom data are not available, would have a grey ribbon.