HMO to Allow Consumers to Rate Hospitals, Doctors

One of the nation’s leading HMOs will allow members who have an operation to rate the hospital, surgeons and nurses in a report card that will be given to other patients facing the same surgery.

The program announced Monday by Oxford Health Plans Inc. is designed to improve the performance of surgical teams and let new patients choose teams that have the most experience, highest success rates and best bedside manner.

Oxford will unveil the program today as part of an overhaul designed to address the most frequent gripes about managed care and to save the company money.

In California, where several of the nation’s largest health plans are based, HMO executives described Oxford’s announcement as an interesting development. They said they know of no California health plan with a program similar to the one Oxford is proposing.

“We support comparative data that give the consumer useful information and empower them to make decisions about their own health,” said Susan Whyte Simon, a spokeswoman for PacifiCare Health Systems, a Cypress-based HMO.

Oxford’s new surgery program abandons the current, sometimes-haphazard system of arranging an operation. The company is asking surgeons to set up teams of medical professionals to provide a specific service at a preset fee.

Examples include delivering a baby or performing a heart bypass or a hip replacement.

Typical team members would include a hospital, other surgeons, anesthesiologists, physical therapists and visiting nurses.

Oxford has already set up more than 200 teams and hopes to establish an additional 500 this year.

“Most people have no idea about the training, background and success rate of providers before they undergo surgery,” Oxford Chairman Stephen Wiggins said.