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BlueCompare adds quality related performance information to Provider Finder® for BlueChoice® and BlueChoice Solutions networks (including physicians who service HealthSelect, UT Select and other group accounts) through 2 programs:
Evidence Based Measure (EBM) - The EBM evaluation uses BCBSTX claims and enrollment data to calculate performance against indicators that cover significant areas of care in diabetes, cardiovascular disease, preventive care and other health services. Performance on the indicators is attributed to physicians based upon their involvement in treating the qualifying patients. Where there are indicators for a specialty and sufficient data is available, physicians at or above the threshold will be recognized with a blue ribbon. When the physician practices in a group, the EBM information reflects the performance of all the physicians in the same specialty within that group.
Additional Information Regarding EBM
Bridges to Excellence® (BTE) recognition
Blue Cross and Blue Shield of Texas (BCBSTX) has implemented a Bridges to Excellence program to recognize and reward health care providers who demonstrate implementation of sound management of complex patients and deliver safe, timely, effective and efficient patient-centered care. Therefore, physicians in the BlueCompare measured specialties that are currently recognized by the Bridges to Excellence organization in their Diabetes Care Link or Cardiac Care Link programs will display a BlueCompare Blue Ribbon.
To obtain additional information about how to become BTE Recognized, please visit their Web site at http://www.bridgestoexcellence.org/.
Once you are a recognized Physician with BTE and need more information regarding BCBSTX’s incentive program please contact Jill Brooks via email. Her address is Jill_Brooks@bcbstx.com.
EBM Reports
In 2010, BCBSTX is using revelationMDTM to display EBM Performance Reports in a secure portal online at portal.revelationmd.com. Login information was mailed to physicians (with reportable data) or to the group practice’s administrator. For assistance with logging in, please follow the instructions provided on the revelationMDTM Web site. Also, you can contact either your group practice administrator (if applicable) or your local Professional Provider Network office for assistance.
EBM Opt Out
A physician can opt out and choose to not display the EBM information in Provider Finder for calendar year 2010 by filling out a form available here.
BlueCompare Inquiries and Reviews
Blue Cross and Blue Shield of Texas (BCBSTX) makes every effort to ensure our network providers understand the practice information listed in our BlueCompare Web tool. If you are not satisfied with your BlueCompare Evidence Based Measures (EBM) information, you have the right to request a formal review.
Obtain additional information regarding Inquiries and Reviews
Visit BlueCompare
We invite you to become familiar with the BlueCompare consumer information tool by viewing more BlueCompare information in Provider Finder.
Questions?
If you still have questions, please see the Frequently Asked Questions or contact your local Professional Provider Network office.
Note
The BlueCompare tool is provided for informational purposes only. BlueCompare information is available to assist members and non-members in the selection of a health care provider. It is not intended to be a recommendation to consumers. Selection of a health care physician is a personal choice, and consumers should not base decisions solely on Evidence Based Measures designations displayed in BlueCompare. BlueCompare is based on BCBSTX PPO and POS claims and membership data and may not be indicative of the physician's overall practice.
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