How Plans Rate Physicians

Some managed-care plans don't just emphasize patient satisfaction and higher quality care, they actually reward it. The higher a physician scores on patient-satisfaction surveys and on the plan's reviews of patients' medical charts the more he or she is likely to be paid by the plan. These bonuses serve as incentives to boost quality-of-care. Here are some of the questions plans ask to determine whether a physician is meeting the plan's goals:

Patient Surveys

  • How easy is it to get an appointment for a checkup?
  • What's the average waiting time in a doctor's office?
  • How much personal concern does a doctor show for patients?
  • How readily were patients able to obtain their follow-up test results?
  • Would patients recommend their doctor to others?
  • What percentage of a doctor's patients transfer to another physician's care each year?

Chart Reviews

  • Do doctors provide regular immunizations for children? Breast cancer checks for women? Prostate cancer checks for men? Colon cancer checks for people over age 50?
  • Have periodic screening guidelines been met?
  • Were laboratory/radiology results reviewed and interpreted?
  • Is the working diagnosis consistent with the complaint and is the treatment plan appropriate?
  • Have consultations been used appropriately?

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