Tiering and Pay for Performance

The MMS advocates to ensure that tiering, pay for performance programs and other public reports of physician performance are accurate and scientifically valid.

Overview and Background 

• MMS Litigation Against the Group Insurance Commission
• Appealing Your GIC Tier Designations: What Physicians Can Do
• Appealing Your GIC Tier Designations: Contact Information
• What Patients Should Know About Physician Tiering
• MMS Principles for Tiering of Physicians by Health Plans 

Details of the 2010 GIC Tiering Programs, by Health Plan

• Fallon Community Health Plan (.pdf, 2 pages)
• Harvard Pilgrim Health Care (.pdf, 2 pages)
• Health New England (.pdf, 2 pages)
• Neighborhood Health Plan (.pdf, 2 pages)
• Tufts Health Plan (.pdf, 2 pages)
• Unicare (.pdf, 8 pages)

MMS Stance

• Programs for monitoring the quality and costs of health care must include:  

MMS Achievements 

• The MMS has filed litigation in Suffolk Superior Court, alleging that the state Group Insurance Commission’s “Clinical Performance Improvement Program” is misleading to patients, and inaccurately issues reports on the quality of care provided by individual physicians.