Quality improvement is an essential element in the delivery of care and services by Blue Medicare PPO.  To define and assist in monitoring quality improvement, the Blue Medicare PPO Quality Improvement Program focuses on measurement of clinical care and service delivered by Participating Physicians/Professional Providers against established goals. 

Participating Providers must cooperate with the independent quality review and improvement organization approved by CMS, TMF Health Quality Institute (formerly known as the Texas Medical Foundation).  TMF is a non-profit Quality Improvement Organization (QIO) that partners with hospitals, physicians, nursing homes, home health agencies, health care associations, and health departments in Texas.  TMF's goal is to improve the quality of health care for all patients.  For more information, visit the TMF site.

Your Medicare Advantage amendment states the following, "Provider shall also participate in CMS and HHS quality improvement initiatives."  Click here to obtain more information.

For additional information, please refer to the Blue Medicare PPO Supplement and to the BlueChoice Provider Manual.