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List of Evidence Based Measures - 2013

Blue Cross and Blue Shield of Texas (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 2013 BlueCompare EBM evaluation.


#CategoryDescription 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, 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 – Interventional, 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 – Interventional, Cardiovascular Disease – Non-interventional, Family Practice, Geriatric Medicine, Internal Medicine Informational Only: Endocrinology

8

Antibiotic Use


Appropriate Treatment for Children with Upper Respiratory Infections (URI)
 

 

Allergy-Immunology, Family Practice, Pediatric Allergy and Immunology, Pediatrics Informational Only: Pediatric Pulmonary Disease

 

9

Medication Monitoring

Use of Long-term Control Drugs for Persistent Asthma 

Allergy-Immunology, Family Practice, Internal Medicine, Pediatric Allergy and Immunology, Pediatric Pulmonary Disease, Pediatrics, Pulmonary Disease

10

Imaging

Appropriate Use of Imaging in Low Back Pain Assessment 

Family Practice, Geriatric Medicine, Internal Medicine
Informational Only: Neurology



Informational Only:

The measures shown below were not used to evaluate any physician’s EBM performance in 2013. The information is provided to physicians as feedback on performance.

#CategoryDescription 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

Cancer

Follow-up After Initial Diagnosis and Treatment of Colorectal Cancer: Colonoscopy 

Colon-Rectal Surgeon, Family Practice, Gastroenterology, Geriatric Medicine, Internal Medicine, Oncology

4

Cancer

Prostate Cancer: Cancer Surveillance 

Family Practice, Internal Medicine, Oncology, Urology

5

Cancer

Prostate Cancer: Three Dimensional Radiotherapy 

Family Practice, Internal Medicine, Urology

6

Respiratory Infections

Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis 

Allergy-Immunology, Family Practice, Internal Medicine, Pulmonary Disease

7

Respiratory Infections

Pharyngitis Treatment for Children 

Allergy-Immunology, Family Practice, Pediatric Allergy – Immunology, Pediatric Pulmonary Disease, Pediatrics

8

Well Child Visits

Well Child Visits 3-6 years 

Family Practice, Pediatrics

9

Hepatitis C

Hepatitis C Viral Load Test 

Family Practice, Gastroenterology, Internal Medicine

10

Rheumatoid Arthritis

Disease modifying Anti-Rheumatic drug Therapy for Rheumatoid Arthritis 

Family Practice, Internal Medicine, Rheumatology

11

Medication Monitoring

Monitoring for Patients on Persistent Medications: ACEI/ARB 

Cardiovascular Disease – Interventional, Cardiovascular Disease – Non-interventional, Family Practice, Geriatric Medicine, Internal Medicine, Nephrology

12

Medication Monitoring

Monitoring for Patients on Persistent Medications: Digoxin 

Cardiovascular Disease – Interventional, Cardiovascular Disease – Non-interventional, Family Practice, Geriatric Medicine, Internal Medicine

13

Medication Monitoring

Monitoring for Patients on Persistent Medications: Diuretics 

Cardiovascular Disease – Interventional, Cardiovascular Disease – Non-interventional, Family Practice, Geriatric Medicine, Internal Medicine, Nephrology

14

Medication Monitoring

Monitoring for Patients on Persistent Medications: Anticonvulsants 

Family Practice, Geriatric Medicine, Internal Medicine, Neurology


 
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