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Minnesota insurer unveils doctors' ratings over their objections

Minnesota physicians are fighting an effort by the state's second-largest insurer to assign stars to doctors in its network listings based on quality and efficiency scores on its new Premium Designation program. Medica, based in Minnetonka, Minn., launched its ratings program Jan. 19 as planned, despite a request from the Minnesota Medical Assn. to delay and address what it said were errors and inaccuracies in the program. Medica has 1.6 million members in Minnesota, as well as in North Dakota, South Dakota and Wisconsin. The company said 96% of Minnesota physicians and other health care professionals are in its network. The Medica program uses a modified version of UnitedHealthcare's Premium Designation program, which United spokesman Daryl Richard said the company uses in 138 markets. United, which is based in Minnetonka as well, doesn't sell insurance in Minnesota because state law prohibits for-profit HMOs. Medica contracted with United to rate its network physicians, Medi ...

Michigan health system paying doctors for their advice

Some doctors at a Detroit-area hospital will start being paid for advice on how to improve patient safety and satisfaction, as well as care quality and efficiency. St. John Macomb-Oakland-Hospital, Oakland Center in Madison Heights, Mich., in January signed a two-year management services agreement with the new Oakland Physician Professional Management Group. More than 50 physicians, out of the several hundred on the medical staff, are part of this group. Most are in private practice, and both specialists and primary care physicians are included. Those participating will be paid for their time working on various projects. The hospital sees the agreement as a means of achieving greater alignment with physicians, as well as meeting various quality and outcome goals, such as reducing bedsores and falls. "This is just another way to work with our physicians and to engage our medical staff," said Terry Hamilton, senior vice president of operations with St. John Providence Health Sys ...

Nonprofit hospitals' profits rise amid declining revenues

Nonprofit health care institutions improved their fiscal shape in 2009, according to an annual report issued by Moody's Investors Service. Analysts at the credit ratings service, however, predict that hospital systems won't be able to continue to improve their margins because they are still seeing revenues decline. Their improved margins for 2009 were a result of cost-cutting. "If you don't have revenue growth, it is hard to grow the organization," said Kay Sifferman, vice president and senior credit officer at Moody's in Dallas. The Aug. 25 report, "Not-for-Profit Healthcare Medians for Fiscal Year 2009 Show Improvement Across all Major Ratios and all Ratings Categories," included information gathered from 401 nonprofit hospitals. The report said median operating margins improved from 1.8% in 2008 to 2.3% in 2009. Larger entities fared better than smaller ones. The operating margins of the 50 largest institutions in the survey grew from 2.8% in 2008 to 3.5% in 2009. The op ...