Dr. Reece discuses the legality of ranking doctors and the push under way in the insurance industry.

More health plans are rating physicians on quality and efficiency measures and are designing insurance products classifying physicians in tiers. Plans are given incentives to members to select certain high performing physicians. The GW legal analysis concludes transparency is critical when designing a tiering process.

As a physician who is primarily out of network on many plans this can have a significant impact on my practice---depending on how actively the insurers push or cajole their patients to the most cost effective provider.  If they simply provide a website for informational purposes... I suppose we'll be fine.  If,however, they call patients and try to direct them "forcefully",  who knows.  Some patients will see this for what it is and will be upset at the intrusion, but others will certainly listen and perhaps move on.   In the future I envision a situation where the industry not only tiers the physician ---but they will then combine that with their "cost" ranking--- to establish a punitive co-pay to see each doc.   Once the patient becomes financially responsible for their decision then I think the  situation will prove to be a problem for many practices.