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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. View additional information about the EBM guidelines, such as the clinical intent and sponsoring organizations. The measures listed below were used for scoring physician performance in the 2009 BlueCompare EBM evaluation.
# |
Category |
Description |
Measured Working Specialties |
1
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Preventive Screening
|
Mammography Screening
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Family Practice, Geriatric Medicine, Internal Medicine, Obstetrics-Gynecology
|
2
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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
|
Diabetes
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Diabetic Retinal Exam (Annual)
|
Endocrinology, Family Practice, Geriatric Medicine, Internal Medicine, Nephrology
|
5
|
Diabetes
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Glycosylated Hemoglobin (HbA1c) Test for Diabetics (Annual)
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Endocrinology, Family Practice, Geriatric Medicine, Internal Medicine, Nephrology
|
6
|
Diabetes
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LDL Monitoring for Diabetes (Annual)
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Cardiovascular Disease – Non-interventional, Endocrinology, Family Practice, Geriatric Medicine, Internal Medicine, Nephrology
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7
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Cardiovascular Disease
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Treatment of Cardiovascular Conditions: Monitoring Lipid Levels (Annual)
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Cardiovascular Disease – Non-interventional, Family Practice, Geriatric Medicine, Internal Medicine
|
8
|
Preventive Care
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Annual Visual Field Tests for Patients with Primary Open Angle Glaucoma
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Ophthalmology
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9
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Antibiotic Use
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Appropriate Treatment for Children with Upper Respiratory Infections (URI)
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Allergy-Immunology, Emergency Medicine, Family Practice, Pediatrics, Urgent Care
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10
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Medication Monitoring
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Use of Long-term Control Drugs for Persistent Asthma
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Allergy-Immunology, Family Practice, Geriatric Medicine, Internal Medicine, Pediatric Pulmonology, Pediatrics, Pulmonology
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11
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Complication Avoidance
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Risk-Adjusted Complication Likelihood for Surgeries: Appendectomy or Cholecystectomy
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General Surgery
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12
|
Imaging
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Appropriate Use of Imaging in Low Back Pain Assessment
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Emergency Medicine, Family Practice, Geriatric Medicine, Internal Medicine, Neurological Surgery, Neurology, Orthopedic-Spine, Orthopedic Surgery, Physical Medicine & Rehab, Urgent Care
|
13
|
Imaging
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X-ray prior to MRI/CAT Scan in the Evaluation of Lower Back Pain
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Emergency Medicine, Family Practice, Geriatric Medicine, Internal Medicine, Neurological Surgery, Neurology, Orthopedic-Spine, Orthopedic Surgery, Physical Medicine & Rehab, Urgent Care
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14
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Cancer
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Radiation Therapy Following Breast Conserving Surgery
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General Surgery, Oncology
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15
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Cancer
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Follow-up After Initial Diagnosis and Treatment of Colorectal Cancer: CEA
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Colon-Rectal Surgery, Family Practice, Gastroenterology, General Surgery, Geriatric Medicine, Internal Medicine, Oncology
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16
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Cancer
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Follow-up After Initial Diagnosis and Treatment of Colorectal Cancer: Colonoscopy
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Colon-Rectal Surgery, Gastroenterology, General Surgery, Oncology
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Informational Only:
The measures shown below were not used to evaluate any physician’s EBM performance in 2009. The information is provided to physicians as feedback on performance.
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