Doctors Rate Best & Worst Payers

• Survey fielded to 307,000 US physicians

• Total respondents: 10,214 US physicians

• United States was divided into 9 geographic regions to account for differing insurance companies by region

• Fieldwork conducted by Medscape from 9/23/11 to 11/7/11

• Data collected via third-party online survey collection site

Picking a favorite insurer is not easy when so many physicians told us they find almost all payers to be problematic at times. Still, a number of factors make some insurers rise above the others. The nation's largest insurers scored highest. That "honor" is somewhat mitigated, however, because the same companies also show up on physicians' worst insurer list. A Blues plan was named one of the best and is a major payer in nearly all geographic regions. Of those physicians who named a favorite, 29% say a Blues plan is their best insurer.  Three in 10 physicians said they do not know which plan is best. Many doctors are employees and earn a straight salary or work in practices where administrative staff handle most insurance issues.

Blues plans scored the highest in every one of the 32 specialties surveyed. This ranged from 36% of pulmonary medicine specialists to 14% of HIV/AIDS specialists choosing Blues plans as the best payers. Primary care physicians also said Blues plans were their best insurers: 29% of family physicians and internists said a Blues plan is their choice for best insurer. United Healthcare was the number-2 choice of family physicians (9%), internists (10%), and obstetrician/gynecologists (11%), whereas Aetna was the second choice among pediatricians (10%).

Aetna was also the number-2 choice of gastroenterologists (15%), general surgeons (11%), ophthalmologists (10%), orthopaedic surgeons (8%), plastic surgeons (11%), and urologists (13%).

Medscape asked, "What factors were the most important to your having a positive opinion of an insurer?" Clearly, physicians focus on the financial bottom line when evaluating insurers. A majority of physicians (54%) said amount of payment is the most important factor in having a positive opinion about a health plan. However, "easy to do business with" and "frequency of denials" also were important to more than a quarter of physicians.

Insurers often talk about being easy to do business with, having fewer claims denials, and paying more quickly. Approximately 15% of physicians said the top factor is whether the insurer is easy to do business with, whereas 13% ranked frequency of denials as being crucial. Physicians are willing to wait a little longer for reimbursement if the reimbursement is higher.

Nationwide, respondents noted that Blues plans pay noticeably faster than all other insurers. One in 5 doctors said a Blues plan was the speediest payer. In second position -- but significantly lower -- were United Healthcare and Aetna at 7%. On a regional basis, physicians in the Northwest (18%) said Absolute Total Care is the fastest payer followed by Humana at 7%.

Physicians in the South Central, Southeast, Southwest, and the West listed Humana as number 1 for quick reimbursements. One quarter of doctors cited a smaller regional insurer as the speediest payer. Four in 10 doctors nationwide said they do not know which insurer is best. That is likely because many physicians are either employed or work in practices where the administrative staff handle insurance matters.

Doctors considered not only their current insurers, but also those they previously participated with. United Healthcare had the dubious distinction of being voted the worst insurer nationwide in the eyes of the highest percentage of physicians (14%), followed by Blues plans (10%), Aetna (8%), and Cigna and Humana (both at 6%). These plans also ranked highest as best insurers by a plurality of physicians. That is not necessarily contradictory because the major payers are most likely to win praise and complaints as a result of the volume of their dealings with doctors.

There was less fervor to name some insurers as the worst than there was enthusiasm to name them the best. For example, the Blues plans got 28% of votes for best insurer but only 10% of votes for worst.

Almost 90% of the more than 4700 responses were negative about insurers, ranging from mild frustration to fury, mostly about denials of payment and difficulty getting straight answers from health plans.  Therefore please understand that although BC was rated "best", it was not necessarily rated a good insurance.  This is all relatively speaking which makes makes a huge difference.