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List of Evidence Based Measures - 2009

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	Preventive Screening	Mammography Screening	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	Diabetes	Diabetic Retinal Exam (Annual)	Endocrinology, Family Practice, Geriatric Medicine, Internal Medicine, Nephrology
5	Diabetes	Glycosylated Hemoglobin (HbA1c) Test for Diabetics (Annual)	Endocrinology, Family Practice, Geriatric Medicine, Internal Medicine, Nephrology
6	Diabetes	LDL Monitoring for Diabetes (Annual)	Cardiovascular Disease – Non-interventional, Endocrinology, Family Practice, Geriatric Medicine, Internal Medicine, Nephrology
7	Cardiovascular Disease	Treatment of Cardiovascular Conditions: Monitoring Lipid Levels (Annual)	Cardiovascular Disease – Non-interventional, Family Practice, Geriatric Medicine, Internal Medicine
8	Preventive Care	Annual Visual Field Tests for Patients with Primary Open Angle Glaucoma	Ophthalmology
9	Antibiotic Use	Appropriate Treatment for Children with Upper Respiratory Infections (URI)	Allergy-Immunology, Emergency Medicine, Family Practice, Pediatrics, Urgent Care
10	Medication Monitoring	Use of Long-term Control Drugs for Persistent Asthma	Allergy-Immunology, Family Practice, Geriatric Medicine, Internal Medicine, Pediatric Pulmonology, Pediatrics, Pulmonology
11	Complication Avoidance	Risk-Adjusted Complication Likelihood for Surgeries: Appendectomy or Cholecystectomy	General Surgery
12	Imaging	Appropriate Use of Imaging in Low Back Pain Assessment	Emergency Medicine, Family Practice, Geriatric Medicine, Internal Medicine, Neurological Surgery, Neurology, Orthopedic-Spine, Orthopedic Surgery, Physical Medicine & Rehab, Urgent Care
13	Imaging	X-ray prior to MRI/CAT Scan in the Evaluation of Lower Back Pain	Emergency Medicine, Family Practice, Geriatric Medicine, Internal Medicine, Neurological Surgery, Neurology, Orthopedic-Spine, Orthopedic Surgery, Physical Medicine & Rehab, Urgent Care
14	Cancer	Radiation Therapy Following Breast Conserving Surgery	General Surgery, Oncology
15	Cancer	Follow-up After Initial Diagnosis and Treatment of Colorectal Cancer: CEA	Colon-Rectal Surgery, Family Practice, Gastroenterology, General Surgery, Geriatric Medicine, Internal Medicine, Oncology
16	Cancer	Follow-up After Initial Diagnosis and Treatment of Colorectal Cancer: Colonoscopy	Colon-Rectal Surgery, Gastroenterology, General Surgery, Oncology

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.

#	Category	Description	Measured Working Specialties
1	Preventive Screening	Chlamydia Screening for Women	Family Practice, Internal Medicine, Obstetrics-Gynecology
2	Diabetes	Monitoring for Diabetic Nephropathy	Endocrinology, Family Practice, Geriatric Medicine, Internal Medicine
3	Appropriate Testing	Otitis Media with Effusion: Hearing Tests	Family Practice, Otolaryngology, Pediatrics