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Summary:

Medical appointment booking startup ZocDoc last week rolled out an online guide to the new health insurance exchanges, including grades for health plans. Now it explains how it arrived at those grades.

Ahead of the new — and for some, confusing and controversial — health insurance exchanges launching in October, ZocDoc last week rolled out an online guide to the new marketplaces.

Intended to help patients navigate the brave new world of health insurance, it included an overview of the mechanics of the system, such as cost and eligibility, as well as a particularly interesting section that graded the health plans on the availability of their doctors, the accuracy of their doctor directory and customer service.

One thing the guide didn’t include, however, was a clear explanation of how those grades were determined.

When ZocDoc first sent me a note about the new guide, one of my first questions was about the origin of the data. At first, the company, which enables people to book doctors appointments online, just said the grades were mostly based on their internal data and other “proprietary” sources. When I pressed for more details, they said they used appointment booking data, as well as independently-collected data on the accuracy of carriers’ online doctor directory and access to customer service.

Considering that I only planned a brief note about the guide, I thought that sufficed and published a few lines about the new guide. But, the next day, the post attracted a critical comment, maligning, among other things, the guide’s omission of a methodology section.

It seems that comment may not have landed on deaf ears, because on Monday ZocDoc updated its online guide with a brief section explaining how it arrived at its grades.

You can see more details on its site, but the company explains that its three grades reflect three metrics:

  • Doctor availability, which measures the availability of appointments with in-network doctors on ZocDoc;
  • Doctor directory, which evaluates the accuracy of a health plan’s online doctor directory (which ZocDoc determined by calling doctors listed in the directories and verifying the information); and
  • Customer service, which assesses the quality of a carrier’s customer service line (ZocDoc called the helplines and measured how long it took to speak with an operator and get a reply to the question, “How do I find an in-network doctor?”).

While it’s true that other resources, like U.S. News and World Report and Consumer Reports, offer more comprehensive and in-depth rankings on health plans, I think it’s interesting to see ZocDoc open up its data to help patients make decisions. It shouldn’t be the only resource patients use in evaluating health plans. But given its user base (2.5 million people use the site every month) and the trust the company has developed with its customers, ZocDoc can play a helpful role in educating patients about changes in the healthcare system. Hopefully, the company will find other ways to use its data to share insights about the health system.

Also, although it would have been nice to see the company be even more open about its evaluation process — for example, by sharing the number of phone calls it made to assess the carriers’ directories and helplines — it’s a positive sign that ZocDoc, which has built its service on the idea that patients need more information about doctors, ultimately opted for more transparency around its grading system.

Even though this resource isn’t core to the company’s business, patients don’t get nearly enough transparency when it comes to health information and more corporate disclosure is always a good thing.

Image by karen roach via Shutterstock.

  1. Grading on doctor availability is a good start, but evaluating the coverage/cost terms of each plan would be more helpful such as the deductible, out of pocket maximums, and how inclusive the procedure/medication/testing coverage is would be more beneficial. What is insurance anyway, but a financial protection from incurred health issues not just customer service.

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  2. Unless all health companies offered a limited number of plans with identical benefit structure and cost components (the copays, deductibles and OOO limits mentioned above), then grading as scotthao suggests will be extremely hard to accomplish – likely impossible. And then how would that information be presented? With a single FICO-like score? A series of scores for different aspects? How would adjustments for consumer preferences and real or perceived value differences that different consumers might have be accounted for?

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  3. Mr. Smith goes to Washington Thursday, August 29, 2013

    The truth isn’t as it appears. Regarding the first metric: ” Doctor availability, which measures the availability of appointments with in-network doctors on ZocDoc.” This is hardly a fair assessment of the overall availability of doctors. One could argue that ZD’s listed doctors could be a fair assessment, representing a sample poll of the Nation’s entire health programs. However, ZocDoc is a niche company. It targets only small mom/pop practices. Most of the healthcare provided in the country is by large enterprises. These enterprises have denied much of the overtures to them made by ZocDoc. They all run sophisticated IT and the interface would reek havoc on their logistics if they used ZocDoc. So, the data from ZocDoc doesn’t really apply.

    On the second metric, “Doctor directory, which evaluates the accuracy of a health plan’s online doctor directory (which ZocDoc determined by calling doctors listed in the directories and verifying the information)”, This is complete nonsense. ZocDoc is trying to make a far stretch by saying that if directories don’t match their data, then the directories must be out of date. But I would scream for the complete opposite. I can’t begin to describe how inaccurate the marketing lead information, stored in the sale’s team database, is! Further more, from firsthand experience, sales personnel will have probably 30 out of 100 calls, where they step into the call with accurate information.

    On the third metric, “Customer service, which assesses the quality of a carrier’s customer service line (ZocDoc called the helplines and measured how long it took to speak with an operator and get a reply to the question, “How do I find an in-network doctor?”).” The truth is, WHO CALLS ANYMORE ANYWAYS? The day’s of “I hate using the internet for help, I’ll just call.” Is long over! Most people look at their insurance company’s website and find a doctor in network. Then they call or book directly on the doctor’s website after googling them.

    So, that’s 1,2,3 strikes – OUT! But, to be honest, no one likes to admit when their idea is wrong… especially when they’ve take more than $55 million in venture capital.

    - Yours truly
    (Disclosure: I am not a ZocDoc representative or speaking on their behalf. Furthermore, I am not an authority on this subject matter. This is my personal opinion – not facts. No matter how small the gap between the two are.)

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  4. Interesting article in the Economist “Zesty in the UK and Zocdoc in the US banking on Healthcare being the next sector to take advantage of eCommerce” http://www.economist.com/blogs/schumpeter/2013/08/online-healthcare

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