A survey of Rhode Island physicians conducted as part of a health insurance rate approval process has found dissatisfaction with reimbursement rates, skepticism about pay-for-performance policies, and mixed feelings about incentive programs.

The results of the survey, which was conducted May 2 to 9 through the Rhode Island Medical Society, were released last week by Health Insurance Commissioner Christopher F. Koller’s office, with a big caveat – that only 179 doctors, or 6.9 percent of those polled, responded.

“Considerable caution must be taken in drawing definitive conclusions because of the low response rate,” the survey report says. “Furthermore, the survey has no benchmarks of previous measures or identical surveys in other states.”

Nevertheless, the responses are of interest because they offer the first larger-scale physician perspective on issues Koller is charged with addressing:

The survey was e-mailed to doctors through the Medical Society’s distribution system; no data is available on the demographics of the providers who responded, Koller’s office said.

In general, the survey found “general dissatisfaction of providers with both carriers related to fair treatment of providers – particularly as it relates to rate adequacy, promotion of affordability and quality of health care, and promotion of health systems improvements,” the survey report says. Blue Cross & Blue Shield of Rhode Island’s ratings were “relatively higher” than UnitedHealthcare of New England’s on all metrics.

Only 30.8 percent of respondents said local insurers’ rates, overall, were “excellent,” “very good” or “good,” and this was the area in which doctors commented the most. Sixty-two-and-one-half percent rated United “poor” in this area, versus 24 percent for Blue Cross; only 13 percent of respondents rated United “excellent,” “very good” or “good.”

Blue Cross also scored much better on prompt and efficient claims processing, with 71.1 percent of respondents rating it “excellent,” “very good” or “good,” while United was rated “fair” or “poor” by 68.7 percent of respondents.

Asked whether local insurers’ payment strategies promote the affordability and quality of health care in Rhode Island, only 30.9 percent of respondents rated carriers as “excellent,” “very good” or “good” at this, and many expressed negative opinions of “pay-for-performance” programs. In general, Blue Cross was described more positively when it came to incentive programs, with comments such as “BCBSRI has been working in partnership and motivates for change,” while United was described as “remote and rigid,” among other things.

The complete survey report is available at www.ohic.gov.