Insurers hold physicians to higher quality standards

The new federal health care law is causing insurers to hold physicians and hospitals to higher quality standards, according to an article in the Chicago Tribune.

The Tribune reports that the new regulations call for state regulated health plans to spend at least 80 percent of premium dollars on medical care, which causes insurers to lose profits.  In response, insurers are using quality standards to limit patients' selections to top-performing providers that can deliver the highest-value care.

The American Medical Association has expressed concerns that doctors could be penalized and omitted from networks if they provide services for populations that need more medical care, such as elderly consumers who are more apt to suffer from chronic conditions.

(Sources: Chicago Tribune, September 4, 2010; The Advisory Board Daily Briefing, http://advisory.com, September 8, 2010)