HMO Releases Scorecard on Doctor Groups

The firm's so-called quality index marks the first time an HMO has made rankings of its medical groups available to the public.

"This is one way of having the voice of the consumer more clearly heard," said Sam Ho, medical director and vice president of the Santa Ana-based HMO. "Consumers are going to be armed with information about medical groups and therefore can vote with their feet. Because of this, patient care will be improved."

The quality index identifies the medical groups' top performers--those in the top 10% of a particular category--with a ribbon printed alongside their names in PacifiCare's new provider directory.

The directory does not list the low scorers, but members can find out how their medical groups fared by writing to PacifiCare.

The directories are being released this week, the start of open enrollment season, when many HMO members switch their health plans.

The 120 medical groups named in the rankings treat 1.3 million Californians and employ 30,000 physicians. PacifiCare executives say they plan to compile similar rankings next year for the nine other states where it operates.

Consumer activists welcomed PacifiCare's decision to publish the index, saying it was an important first step to give consumers critical information.

"It's a very good idea," said Peter Lee, director of consumer protection programs for the Center for Health Care Rights, a Los Angeles nonprofit group. "In California, care is being organized and delivered more and more at the medical group level. Consumers need to understand that the choices they make between medical groups can be as or more important than the choice they make between health plans."

But reaction was mixed among doctors in the medical groups ranked by PacifiCare. Some protested the HMO's decision to publish the rankings, saying they were based on incomplete data, according to Ho.

Others, like Marvin Gordon, chief medical officer of Monarch HealthCare in Mission Viejo, were "cautiously optimistic."

"These rankings are not a true reflection of quality," Gordon said, "but it is a beginning of what we need to do as physicians--develop [a way to measure] our performance. We will use this information to tell our physicians that they can do even better."