A new tiered health plan from Blue Cross and Blue Shield of Minnesota will require members to pay more if they use lower quality doctors who charge more for services, the St. Paul Pioneer Press reports. The plan will rank individual physician groups based on cost, as well as how well physicians perform on five to 23 measures, depending on medical specialty. Only hospitals and clinic groups in competitive markets will be ranked, according to BCBSM. Under the plan, patients will still be able to visit low-ranking doctors or hospitals, but they will pay about 20% more in premiums or deductibles. The insurance company is only offering the tiered plan to employers with self-insured health benefits. The tiers will not affect Medicare beneficiaries or those with independent health insurance. BCBSM said it expects medical costs to decline by 6% to 7% for those who sign up for the plan. David Ploncher, the chief medical officer for BCBSM, said, "The good that can happen with tiering is that it should reward the better-performing providers with good market share." BCBSM attempted to introduce a similar plan last year, though doctors objected to it because they were ranked according to how their affiliated hospitals ranked on quality and cost, rather than by their own clinical results. Ploncher said that the doctors' objections were "understandable" and that the new plan offers a fair and open evaluation system (Olson, St. Paul Pioneer Press, 7/25).

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