Background on Ratings Examinations in New York
In New York some health plans rate the performance of physicians in their networks
based on quality and cost. In August 2007, the New York Attorney General challenged
the actions of health plans that rated physician performance to ensure that health
plans used valid national performance measures and were transparent about their
physician measurement activities.
In late 2007 the plans with physician evaluation programs in place and a number
of plans that expected to roll out evaluation programs in the future entered into
agreements with the New York Attorney General. Among other things, those agreements
detail requirements for physician performance measurement programs and provide for
assessment against those requirements by an independent Ratings Examiner.
Welcome to this report which contains information on how health plans in New York
measure and report on physician performance. NCQA has been appointed by the New
York Attorney General to evaluate and report on methods used by health plans to
assess the cost and quality of physicians in their networks for the plans whose information is included in this report
Health plans are measuring physician performance to provide more
information for their members to use when selecting physicians and may use this
information to structure their networks.
The New York Attorney General requires that health plans meet certain requirements
in the methods they use to measure physician performance.
With the approval of the Attorney General, NCQA evaluates health plan programs
to confirm that health plans use methods that meet the requirements of the New York
As additional plans undergo the Ratings Examiner review,
the results will be included in this report.
This report includes the results of NCQA's review of the plan against the New York Attorney General's requirements. It does not include the actual results of the plan’s measurement
of individual physicians. For additional details about an individual health plan’s
physician performance measurements, please visit that plan’s web
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