Physicians Claim Doc Rating System is Misleading Patients

Cheryl Clark, for HealthLeaders Media , April 20, 2010

The quality metrics used in the score do not capture patient outcomes, and only offer a "cursory view of the overall care provided by a physician."


  • Patient sample size is insufficient.
  • Physicians' recommendations during the process were "often set aside or overturned by CPPI's executive committee.


    On April 16, in a letter to CMA Chief Executive Officer Dustin Corcoran, Blue Shield of California's Chief Medical Officer Meredith Mathews, MD, defended the rating system.

    "We strongly disagree with your statement that CPPI data is not reliable enough to use since it is based on claims data," he wrote. "The CPPI measures all reflect evidence-based medicine and embody services and tests the patient should receive, as agreed upon by the wider medical community. They measure a range of services that are critical to achieving favorable outcomes for cancer patients, diabetics, and patients with heart conditions."

    He also wrote that physicians can correct data before it's published, that physicians "are not penalized, only acknowledged for superior performance" and said that if another doctor provides a patient's service, other doctors that delivered care to that patient would get credit for that service.

    He added that "quality transparency is critical and long overdue. Californians have access to quality information on hospitals and medical groups, but currently have no information on their individual physician."

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