Patients are loyal to their doctors, despite performance scores

March 12, 2014 by Sharyn Alden, Health Behavior News Service
Patients are loyal to their doctors, despite performance scores

Many health insurers now rank their physicians into tiers based on quality and cost and provide financial incentives to members for choosing a doctor in a higher tier. These tiered networks are designed to promote competition and quality improvement among providers.

However, a new study from Health Services Research found that while selecting a tiered doctor for a first-time visit were likely to choose one ranked in the best performing or average tier, patients who had an ongoing relationship with a doctor in a lower performing tier were no more apt to switch than patients with higher ranked doctors.

"These findings are economically important for physicians as these results correspond to a loss in market share of new patients for a doctor in the worse performing tiers compared to those in better tier rankings," said the study's lead author, Anna D. Sinaiko, Ph.D., research scientist in the department of policy and management at the Harvard School of Public Health.

The researchers compared administrative claims and enrollment information of 171,581 patients who were in a tiered physician network that ranked quality performance and efficiency of health plans through the Massachusetts Group Insurance Commission. Twenty percent of physicians were in the top or highest performing tier, 65 percent in the middle and 15 percent were ranked in the lowest performing tier.

Patients with doctors in lower performing tiers may not have had enough financial incentive to switch or may have been unaware of the tiered rankings, suggest the authors.

The study found a low amount of health plan switching and high degree of patient loyalty to physicians they'd seen in the past. In fact, patients with doctors ranked in the lowest performing tier were more likely to switch health plans than other patients. That may be due to patients feeling frustrated that their physician was in low ranked tier or unhappy about having to pay a higher co-pay to see their lower ranked physician, the authors speculate.

Sinaiko pointed out, "Our study underscores the loyalty that patients feel for their own physicians. Likewise, the fact that we observed an impact of tier-rankings on new patient visits also makes sense. Unknown physicians are more likely to be viewed by patients as [more] substitutable than are with whom they already have a relationship."

Robert Zirkelbach, spokesman and vice-president of strategic communications for America's Health Insurance Plans in Washington, D.C., said, "It is important to ensure patients can continue to benefit from the high-value provider networks have established, which are helping to improve quality and mitigate cost increases for consumers as the new health care reforms are taking effect."

Explore further: Administrative demands hurt patient-doctor relationship

More information: onlinelibrary.wiley.com/journa … 111/(ISSN)1475-6773/

Related Stories

Administrative demands hurt patient-doctor relationship

January 8, 2014
(HealthDay)—Administrative demands on doctors, particularly primary care physicians, threaten the patient-doctor relationship, according to an article published Dec. 10 in Medical Economics.

ACP provides overview of health insurance marketplaces

September 25, 2013
(HealthDay)—The opportunities and challenges presented by health care reform are discussed in an article published online Sept. 24 in the Annals of Internal Medicine.

Recommended for you

Sleep better, lose weight?

January 17, 2018
(HealthDay)—Sleeplessness could cost you when it's time to stand on your bathroom scale, a new British study suggests.

Who uses phone apps to track sleep habits? Mostly the healthy and wealthy in US

January 16, 2018
The profile of most Americans who use popular mobile phone apps that track sleep habits is that they are relatively affluent, claim to eat well, and say they are in good health, even if some of them tend to smoke.

Improvements in mortality rates are slowed by rise in obesity in the United States

January 15, 2018
With countless medical advances and efforts to curb smoking, one might expect that life expectancy in the United States would improve. Yet according to recent studies, there's been a reduction in the rate of improvement in ...

Teens likely to crave junk food after watching TV ads

January 15, 2018
Teenagers who watch more than three hours of commercial TV a day are more likely to eat hundreds of extra junk food snacks, according to a report by Cancer Research UK.

Can muesli help against arthritis?

January 15, 2018
It is well known that healthy eating increases a general sense of wellbeing. Researchers at Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) have now discovered that a fibre-rich diet can have a positive influence ...

Your dishwasher is not as sterile as you think

January 13, 2018
(HealthDay)—Your dishwasher may get those plates spotless, but it is also probably teeming with bacteria and fungus, a new study suggests.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.