Late in 2019, Cigna informed me that they would begin soliciting and publishing patient reviews on their Website. I found this to be an interesting development given that I have seen a number of iterations of physician review vehicles including Vitals, Healthgrades, ZocDoc, Yelp, Facebook and Google. Why would an insurance company with a 1.2/5 star rating on consumeraffairs.com get into an already crowded doctor rating space?
There appears to be a simple reason why – namely to provide themselves with yet another lever by which they can cut costs and increase their profits. Cigna has massive corporate overhead, paying their CEO David Cordani $18.9 million in 2019 and Timothy Wentworth their Express Scripts spin-off President $8.8 million. These are only two among the many executives making 7 figure incomes. But how would soliciting physician ratings cut costs? Quite simply – by tying physician ratings to reimbursement.
What Cigna has figured out is that in a market where people are generally dissatisfied with healthcare, ratings will regress to the mean thereby giving Cigna significant leverage to cut performance based pay.
What evidence do I have to support this phenomenon? Well lets start with Mayo Clinic, ranked #1 in the nation. Objectively, Mayo Clinic represents the pinnacle of Academic Medicine nationally and internationally. Their outcomes and quality of care are unmatched. Yet, the Mayo Clinic has a 2.5 of 5 star rating on Google with the first comment being “As a whole, I do not believe the Mayo Clinic is all it’s hyped up to be.”
Here’s another example – One Medical, which just went IPO. Their mission statement is “One Medical is committed to providing the best primary care through exceptional quality, a world-class experience, and second-to-none technology.” Yet their Yelp rating is 3.5 of 5 stars.
So Cigna will pull patients into the fray by soliciting their feedback. Undoubtedly, the providers being reviewed will sink to the inevitable 2.5-3.5 stars mean therefore providing Cigna a rationale for cutting provider reimbursement. For patients this means that your Cigna provider is being asked to do the same quality of work for lower compensation leading to greater dissatisfaction among doctors and patients.
Your best recourse as a Cigna patient? Liberally provide 5 star reviews to Cigna and, if you have a complaint, post it on Yelp. Or Google. Or Vitals. Or Healthgrades. Or ZocDoc. Or Facebook. At least none of the traditional provider rating sites are involved in adjusting reimbursement rates.