Every patient wants the best care available, and with almost 40% of Americans now covered by a high deductible health plan, many are also concerned with finding the best value for the money they spend at their doctor’s office.
Unfortunately, data suggest that it can be tough for most of us to know whether we are getting quality care at a reasonable price. In fact, we might not even be getting the care we need at all. According to a study in The New England Journal of Medicine, only 55% of patients receive the care recommended for their condition or disease.
So, how can a person increase their chances of getting the health care they need? One way is to go to a doctor who is highly rated for the care they provide. Rating systems for physicians have proliferated in recent years, with the internet full of sites designed to give patients a better idea of how well their doctor practices.
However, like doctors, not all rating systems are created equal. Some lack clinically relevant criteria for determining the quality of doctors, and a few have even been criticized for causing health care providers to try to boost their ratings by delivering too much care as a way to keep patients happy.
In a survey of physicians, almost half believed that pressure to obtain better scores on some ratings systems encouraged excessive or inappropriate care, including unnecessary drug prescriptions, blood tests and even hospital admissions.
But not all rating systems necessarily encourage doctors to provide too much care. In fact, some include a component that rewards physicians for providing efficient treatment. One such system is the UnitedHealth Premium designation, which recognizes doctors for providing evidence-based, cost efficient care.
Administered by UnitedHealthcare®, the rating system uses nationally recognized criteria to assess a doctor’s performance and then publishes a ratings designation that is easy for patients to understand. For example, if a physician meets the Premium criteria for providing both quality and cost-efficient care, the doctor is designated as a Premium Care Physician. Physicians who meet Premium’s criteria for providing quality care but not efficiency criteria are designated Quality Care Physicians.
The system is one of the longest running physician measurement programs that evaluates physicians on benchmarks for quality and cost-efficiency, and includes ratings for primary care physicians and doctors practicing in 16 different medical specialties.
Data suggests that the UnitedHealth Premium program is associated with lower complication rates. For example, in a 2017 analysis of commercial claims, patients who saw a Premium Care Physician specialist for a heart stent placement had a 10 percent lower complication rate and were 16 percent less likely to have to redo their procedure. Those who saw a Premium Care Physician specialist for a knee replacement were 15 percent less likely to suffer from complications and 38 percent less likely to have their procedure redone.
Doctors designated as Premium Care Physician may also save money. In all 16 Premium specialties evaluated as part of the UnitedHealth Premium program, patients who saw Premium Care Physicians cost 17 percent less than those who saw non-Premium Care Physicians.
Overall, the data suggests that if patients choose a physician based on a clinically relevant ratings system like the UnitedHealth Premium designation, they may choose providers who provide care with fewer complications at a lower price. That’s good news for patients who are looking for the care they need at a price they can afford and with the evidence-based medicine they deserve.
To learn more about UnitedHealthcare’s Premium Program or to find a doctor with a Premium designation, go here.