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Physician Quality Measurement and Blue Physician Recognition Programs

The Blue Cross and Blue Shield Association (BCBSA) and Blue Cross and Blue Shield of Texas (BCBSTX), have developed transparency programs that provide quality related performance information on the National Doctor and Hospital FinderSM and the BCBSTX Provider Finder®.

Physician Quality Measurement Program (PQM)

The PQM program collects data on nationally endorsed physician quality measures, also known as Evidence Based Measures (EBM). The program will display measurement results on the National Doctor and Hospital Finder and the BCBSTX Provider Finder to assist users in making healthcare decisions.

Your practice’s EBM results shown on your BlueCompare 2014 EBM Summary Report will be displayed on the National Doctor and Hospital Finder beginning July, 2014. Similar information will be displayed in the future on the BCBSTX Provider Finder.

Physician Quality Measurements

  • Below Expectations = more than 1 standard deviation below the mean
  • Meets Expectations = + or - 1 standard deviation from the mean
  • Above Expectations = more than 1 standard deviation above the mean

Practices with less than 30 members for a specific EBM will display "Not Enough Data to Report".

Blue Physician Recognition (BPR)

We will use a BPR indicator on the National Doctor and Hospital Finder site to identify physicians who have demonstrated their commitment to delivering quality and patient-centered care, as determined by BCBSTX.

If you receive a Blue Ribbon for the BCBSTX 2014 BlueCompare program, which means you have met or exceeded quality related performance compared to other doctors, the following symbol will be displayed on the National Doctor and Hospital Finder and the BCBSTX Provider Finder.


Blue Physician Recognition


PQM/BPR Opt Out

A physician can opt out and choose not to display the PQM and or BPR in the National Doctor and Hospital Finder and the BCBSTX Provider Finder by filling out the form .

  • If you choose to Opt Out of displaying your PQM data the following will be displayed:
    • "Physician refused permission to display information."
  • If you choose to Opt Out of displaying your BPR recognition nothing will be displayed
 
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