Physician Efficiency, Appropriateness, & Quality (PEAQ) Program

The PEAQ Program evaluates physician performance in a transparent and multidimensional way. A goal of PEAQ is to work with the physician community to maximize physician efficiency, appropriateness, and quality of care.

The guiding principles of our BCBSTX Physician Efficiency, Appropriateness, and Quality (PEAQ) Program include:

• Metrics - Selecting meaningful measures of health care efficiency, appropriateness, and quality
• Transparency - Equipping physicians with meaningful information about efficiency, appropriateness of care, and quality
• Collaboration - Sharing with physicians to ensure measurement transparency and clinical relevance
• Continuous Improvement - Reevaluating our methodology and measures regularly based on feedback and recent clinical evidence
• Insights - Providing physician-level insights on how to improve overall patient care
• Member Focus – Helping our members identify physicians who are right for them

The three components of the PEAQ program are:

• Efficiency
• Appropriateness
• Quality

For more information, view our PEAQ video and the most current version of the PEAQ Methodology below:

Methodology:

Provider Performance Insights (PPI Reports)

PPIs show how a physician was evaluated and where they rank in comparison to peers. PPIs also include actionable insights to improve future performance. BCBSTX initially developed PEAQ with input from practicing physicians and continue to collaborate with physicians to improve the program. The methodology that corresponds to the August PPIs is PEAQ V1.1

The PPI PDF reports available in August 2022 are located on Availity® for qualified providers. Log in to Availity to view your PPI. If you are not registered for Availity, sign up now by going to Availity and selecting “Register” in the top right corner.  Refer to the PEAQ^SM Program Reports User Guide for information on viewing results in Availity.

Questions? Refer to the PEAQ FAQ or contact PEAQ Inquiries for information about PEAQ, including results and methodology. To request a formal reconsideration proceeding, complete the Reconsideration Request Form and email it to PEAQ Inquiries. Reconsideration requests are allowed for 45 days after reports have been delivered to providers. Requests will be answered beyond the reconsideration request period, but scores will already be finalized.

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX. BCBSTX makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.