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HMO Will Reward Physicians for Quality Care

Debate over the Patients' Bill of Rights is coming to a head in Congress, including a strong provision that would allow patients to sue their HMOs. Whether the bill passes or not, CBS's Sandra Hughes reports that there is one big HMO that's giving doctors an added incentive to keep patients satisfied.

Long-time HMO patient David Santiago says that for years he felt like his doctors were in a hurry to get rid of him. But now that one of California's biggest managed care providers says patient satisfaction is more important than controlling costs, he's hopeful that feeling will change.

"It seemed like you pay your copay, you get a minute with the doctor, and [they] move on to their next patient. It seems like it's getting better, and I hope it'll get better in the future," says Santiago.

Blue Cross, like most HMOs, had based it's doctors' bonuses on how low they kept their budgets, encouraging less testing and shorter office visits. Now it will survey patients' satisfaction and reward doctors for things like giving sufficient tests and treatment follow-up at home.

"We believe this will help patients and physicians build trust in the system," says Dr. Jeff Camille, medical director of Blue Cross of California.

Praises abound for the idea, but so do questions about the HMO's change of heart. Patients' advocates say it's the threat of a federal patients' bill of rights allowing HMO members to sue.

"It's clearly an attempt by the HMO industry to derail HMO reform. To basically say, 'We're going to reform ourselves so we don't need Congress to act or the president to sign the bill,'" says patient advocate Jamie Court.

Alan Steinberg, who wrote a book on HMOs, calls it a smokescreen--charging that HMOs will still pay doctors a low fee per patient whether they [the patients] are satisfied on not.

"I don't think Blue Cross has changed their stripes at all. They want to make money, and they want to make the most money they can," says Steinberg.

Blue Cross and its physicians disagree--claiming a happy patient is easier to treat, and they predict what they do will launch a healthcare trend.
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