Sunday, November 05, 2006

Annals Internal Medicine article"Former CEO Aetna recommends P4P

Dr. John W. Rowe, who is not without impressive academic credentials, recently retired as CEO of Aetna recently authored a five page article in the American college of physician's' journal advocating pay for performance. ACP's position on this is fairly well known and readers will not be surprised to see an article advocating its implementation. However, it does seem a bit audacious to have the former CEO of a major health insurer to pontificate on the "moral basis for physicians...to support efforts to control costs,improve quality of care and participate in pay-for-insurance initiatives."

Some internists members of the ACP might be puzzled as to how an insurance company executive
becomes qualified to lecture them on morality particularly when that insurance company- as well as others- was taken to court by numerous medical societies charging it with various illegal practices designed to seriously curtail payments to physicians and limit patients access to care.

There is, of course, no love lost between practicing physicians and insurance companies in general ,but at least in my experience, Aetna 's reputation in dealing with doctors is near the bottom. The editors of the Annals seem out of touch with real life practicing internists when they choose a former CEO of one of the least liked insurance companies to promote pay for performance.

2 comments:

Anonymous said...

One of my colleagues got his MBA after several years in practice, and went to work for Aetna. Managed it for around a year, and then couldn't take it any more. He's back to clinical medicine. He's a good doc; so it's one positive thing Aetna has done.

Roy M. Poses MD said...

Dr Rowe is not only immediate past CEO of Aetna, but he is still chairman of the board, and is a major stock-holder, owning more than 6 million shares or equivalent. Thus it certainly seems like his commentary was expressing the official Aetna viewpoint.
The problem is that the Annals did not fully disclose these relationships. It listed Rowe as "from Columbia University," and as having only an "employment" relationship with Aetna, not further specified, and holding some Aetna stock, again the amount not specified.
If the Annals wanted to present a position paper from the leadership of Aetna, that is their choice. But IMHO, they should have made very certain that the paper was presented in that light, and should have considered balancing it with another point of view that was not from a commercial managed care organization.
See this post:
http://hcrenewal.blogspot.com/2006/11/lecture-about-pay-for-performance.html/
on Health Care Renewal:
http://hcrenewal.blogspot.com/