Just how does ZocDoc grade health insurance plans?

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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.

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