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BCBSTX uses Evidence Based Measures (EBM) to evaluate aspects of physician performance based on claims and enrollment data. These measures were developed based on nationally recognized evidence based guidelines. Additional information about the EBM guidelines, such as the clinical intent and sponsoring organizations, can be found here.
The measures listed below are used for the 2008 BlueCompare EBM assessment update.
| # |
Category |
Description |
Measured Working Specialties |
| 1 |
Preventive Screening |
Mammography Screening for Women |
Family Practice, Geriatric Medicine, Internal Medicine, Obstetrics-Gynecology |
| 2 |
Preventive Screening |
Cervical Cancer Screening |
Family Practice, Internal Medicine, Obstetrics-Gynecology |
| 3 |
Preventive Screening |
Colorectal Cancer Screening |
Family Practice, Gastroenterology, Geriatric Medicine, Internal Medicine, Obstetrics-Gynecology |
| 4 |
Childhood Immunizations |
Childhood Immunization: Varicella-Zoster Virus (VZV) |
Family Practice, Pediatrics |
| 5 |
Childhood Immunizations |
Childhood Immunization: Measles, Mumps, and Rubella (MMR) |
Family Practice, Pediatrics |
| 6 |
Diabetes |
Diabetic Retinal Exam |
Endocrinology, Family Practice, Geriatric Medicine, Internal Medicine |
| 7 |
Diabetes |
Glycosylated Hemoglobin (HbA1c) Test for Diabetics |
Endocrinology, Family Practice, Geriatric Medicine, Internal Medicine |
| 8 |
Diabetes |
LDL Monitoring for Diabetics |
Cardiovascular Disease – Non-interventional, Endocrinology, Family Practice, Geriatric Medicine, Internal Medicine, Nephrology |
| 9 |
Diabetes |
Monitoring for Diabetic Nephropathy |
Endocrinology, Family Practice, Geriatric Medicine, Internal Medicine |
| 10 |
Cardiovascular Disease |
Treatment of Cardiovascular Conditions: Monitoring Lipid Levels |
Cardiovascular Disease – Non-interventional, Family Practice, Geriatric Medicine, Internal Medicine |
| 11 |
Preventive Care |
Annual Visual Field Tests for Glaucoma Patients |
Ophthalmology |
| 12 |
Antibiotic Use |
Appropriate Management of Upper Respiratory Infections (URI)
|
Emergency Medicine, Family Practice, Geriatric Medicine, Internal Medicine, Pediatrics, Urgent Care |
| 13 |
Medication Monitoring |
Use of Long-term Control Drugs for Persistent Asthma |
Allergy-Immunology, Family Practice, Geriatric Medicine, Internal Medicine, Pediatric Pulmonology, Pediatrics |
| 14 |
Complication Avoidance |
Risk-Adjusted Complication Likelihood for Surgeries |
General Surgery |
| 15 |
Imaging |
Appropriate Use of Imaging in Low Back Pain Assessment (lowback28)
|
Emergency Medicine, Family Practice, Geriatric Medicine, Internal Medicine, Neurological Surgery, Neurology, Orthopedic-Spine, Orthopedic Surgery, Physical Medicine & Rehab, Rheumatology, Urgent Care |
| 16 |
Imaging |
X-ray prior to MRI/CAT Scan in the Evaluation of Lower Back Pain (lowback) |
Emergency Medicine, Family Practice, Geriatric Medicine, Internal Medicine, Neurological Surgery, Neurology, Orthopedic-Spine, Orthopedic Surgery, Physical Medicine & Rehab, Rheumatology, Urgent Care |
| 17 |
Cancer |
Radiation Therapy Following Breast Conserving Surgery |
General Surgery, Oncology |
| 18 |
Cancer |
Follow-up After Initial Diagnosis and Treatment of Colorectal Cancer |
Colon-Rectal Surgery, Family Practice, Gastroenterology, General Surgery, Geriatric Medicine, Internal Medicine, Oncology |
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