NEW YORK—Aetna Inc. has reached an agreement with New York Attorney General Andrew Cuomo to fully disclose to consumers and physicians the cost and quality metrics the insurer uses to rank doctors.

Aetna’s program, known as “Aetna Aexcel,” designates physicians in 12 specialty categories who have passed certain clinical quality and cost efficiency measures. Aetna previously did not identify to consumers how much of the evaluation process was based on cost efficiency and how much on quality measures, but now will do so in accordance with the agreement with the attorney general. Aetna also will retain an oversight monitor who will oversee compliance with all aspects of the agreement and report to the attorney general every six months.

Hartford, Conn.-based Aetna is the second insurer to adopt the attorney general’s model for physician ranking programs, following in the steps of CIGNA Healthcare, a unit of Philadelphia-based CIGNA Corp. Aetna’s agreement, though, covers the insurer’s physician ranking program nationwide, while the CIGNA agreement applies to doctors in New York only.

The agreement arises out of Mr. Cuomo’s ongoing investigation into physician ranking programs. Mr. Cuomo sent letters to Aetna and CIGNA as well as to a unit of Minnetonka, Minn.-based UnitedHealth Group Inc. and several New York-based insurers.

“Choosing a doctor is obviously a very important decision, and the information health care companies provide to consumers must be fair and complete,” Mr. Cuomo said in a statement. “Health insurance companies are beginning to realize if they want to implement a doctor ranking program, they should adopt our national model, which is supported not just by insurers, but also by national physician and consumer groups.”

In a statement, Aetna Chief Medical Officer Dr. Troyen Brennan said the organization is “committed to providing our members with a physician performance evaluation program that is easy to understand and takes into account the input of participating physicians.”

The Chicago-based American Medical Assn. praised Aetna for being the first health insurer to commit to implementing the physician ranking system nationwide. “Patients and physicians throughout the country deserve to be protected from inaccurate ratings, which undermine the physician-patient relationship,” AMA President-elect Dr. Nancy Nielsen said in a statement.

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By Gloria Gonzalez

© Crain Communications, Inc.

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