NBC Nightly News

BRIAN WILLIAMS, anchor:

In California tonight, could it be the start of something big? A major
announcement from one of the biggest insurance companies, Blue Cross. It could totally change the way HMOs do their business. Here with that, NBC’s George Lewis.

GEORGE LEWIS reporting:

Blue Cross in California says the new system is a revolutionary change. Doctors will get bonuses based not on costs, but on patient satisfaction. For doctors with top ratings, the bonuses could be as high as 10 percent of their fees. Blue Cross admits the change comes because customers are demanding better quality medical care.

Dr. JEFF KAMIL (Blue Cross of California): This is done in reaction to marketplace demand. The marketplace has been telling us that change is required.

LEWIS: Under the new system, every patient will receive questionnaires such as this one, asking them to rate the quality of care they’re getting. Among the questions: ‘How much of a problem was it to get the care, tests, or treatment you or a doctor believed necessary,’ and ‘How often did doctors or other health providers spend enough time with you?’

Mr. PETER BURMAN: Blue Cross is now admitting what we’ve been fighting for years for people to understand, is that decisions were being made on the basis of cost reduction as opposed to really patient care.

LEWIS: Peter Burman’s wife Renee died four years ago of liver cancer. This, after her HMO delayed approving the surgery that five different doctors recommended. By the time the surgery was OK’d, the cancer had spread to her lungs.

After Renee died, Peter Burman sued and won a settlement from the HMO. Under the terms of the settlement, he can’t say how much.

Mr. BURMAN: My wife would have been very happy to see that there are changes coming in the system.

LEWIS: HMO critics say doctors will still be paid a fixed amount for each patient they see, an incentive to speed visits.

Mr. JAMIE COURT (Consumers for Quality Care): Having to make ends meet because they only get $15 per patient regardless of whether the patient’s sick or well.

LEWIS: Peter Burman says he hopes things do change, that future patients like his wife Renee will now get the care they need when they need it before it’s too late. George Lewis, NBC News, Los Angeles.