The Blue Cross Blue Shield Association (BCBSA) has partnered with Blue Health Intelligence (BHI) and Motive Medical Intelligence to deliver a Provider Performance Program for efficiency, appropriateness, and quality evaluations for physicians across all Blue plans in a variety of medical, surgical, and primary care specialties.
What Does This Mean for Physicians?
Blue-contracted physicians will be fairly and consistently evaluated to peers across a common set of industry-standard measurements in the following specialties:
Medical |
Cardiology Endocrinology Gastroenterology Nephrology |
Neurology Pulmonary Rheumatology Obstetrics/Gynecology |
Surgical |
Cardiothoracic Surgery General Surgery Ophthalmology Orthopedic Surgery |
Otolaryngology Urology Vascular Surgery |
Primary Care |
Family Medicine Internal Medicine Pediatrics |
|
Each Blue plan will have access to this information, which may be used for member steerage, tiering, network optimization, and other use cases. Notably, members may be able to see a summary of physician performance in Provider Finder®.
How Is This Different Than the Current BCBSTX Physician Efficiency, Appropriateness, and QualitySM (PEAQSM) program?
The current PEAQ program applies to providers contracted with BCBSTX. This program uses principles like PEAQ’s, but different analysis to implement it nationally. BCBSA is partnering with BHI and Motive which allows BCBSTX to expand PEAQ nationally and consistently. This approach will replace PEAQ’s measurements in the future.
The current PEAQ methodology is available for review on our PEAQ page but watch for updates in the future.
Check back later for more information coming on our News and Updates and PEAQ page.