We want to recognize offices that have demonstrated a dedication to
high-quality patient care by achieving the highest rank in quality of care for
the HMO and/or PPO component of the Quality Incentive Payment System (QIPS)
program, the Preventive and Quality Improvement Program (PQIP), or the Primary
Care Advancement Model (PCAM) for measurement year 2018. The quality program is
a comprehensive ranking system of quality measures for primary care offices
with 150 or more commercial HMO/POS and Medicare Advantage HMO members and/or
250 or more attributed commercial PPO members (including National
BlueCard® PPO and Personal Choice® PPO
members).
The programs’ ranking system is based on the Healthcare Effectiveness
Data and Information Set (HEDIS®), a well-established and tested
set of performance measures. The preventive health measures listed below are
used as the baseline for measuring a provider's overall quality performance in
comparison to their peers of the same specialty type:
- childhood and adolescent immunizations;
- childhood and adolescent well visits;
- cancer prevention (screenings for breast, cervical, and colorectal
cancers);
- heart care (beta-blocker treatment after a heart attack);
- asthma care (use of preferred medications for patients with chronic
persistent asthma);
- diabetic care (HbA1c control, eye exam rates, and nephropathy
screening);
- appropriate testing for children with pharyngitis;
- avoidance of antibiotic treatment in adults with acute bronchitis;
- appropriate treatment for children with upper respiratory infection;
- rheumatoid arthritis care (disease-modifying anti-rheumatic drug
therapy);
- fracture care (osteoporosis management in women);
- statin therapy (patients with cardiovascular disease or diabetes).
Congratulations to these primary care offices for
demonstrating overall high quality in these measures and for achieving the
highest rank in quality of care in 2019 (based on 2018 data) for the QIPS
program, PQIP, or PCAM.
HEDIS is a registered trademark of the National Committee
for Quality Assurance (NCQA). Used with permission.