Thursday, July 17, 2008

BlueCross doctors get more time to review profiles

BlueCross BlueShield of Tennessee is taking another shot at easing doctors' concerns about a tool to allow its members to compare quality and costs of care.

Starting Tuesday, doctors have 45 days to review their profiles and update information on their medical claims, which underpins the rating system. The state's largest health insurer, based in Chattanooga, plans to consider doctors' feedback before the online tool goes live Sept. 15.


A rollout was planned for April but was delayed after doctors raised concerns about the accuracy of their individual information and about the use of claims data, which they argued doesn't best reflect quality of the care provided.

Russ Miller, a spokesman for the Tennessee Medical Association, said the Nashville-based trade organization was reserving judgment on the changes by BlueCross until member doctors get a chance to review their profiles and offer feedback.

Nashville surgeon William Edwards Jr., who served on BlueCross' doctors' advisory panel for the effort, said basing data on treatment for an overall condition rather than by each separate test or exam is a more reasonable way to look at costs.

Dr. Jim Jirjis, assistant chief medical officer with Vanderbilt Medical Group, also a member of the panel, said part of the concern in the move toward transparency is doctors might appear to be more costly and as providing less quality care solely because of the profiles of their patients.

"It may not be perfect for everyone, but we feel confident this is good first step," BlueCross spokesman Scott Wilson said. "This is just another tool in (consumer's) tool kit."




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