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As previously communicated, we recently launched an enhanced version of our
Find a Doctor tool that is available
on the IBC website. Below is additional
information about the new features that are now available through this tool.
Patient experience reviews for facilities
Member-submitted experience reviews for network facilities can be viewed on
the Find a Doctor tool. The questions are
similar to those asked in the Healthcare Providers and Systems (HCAHPS) survey
and cover topics such as:
- Overall experience and recommendation
- Provision of follow-up care instructions
- Physician and staff communication
- Cleanliness and restfulness of environment
- Food quality
- Maintenance of privacy and dignity
These reviews can be submitted only by members who log on through our secure
member website. A comprehensive
process is in place to moderate all submitted reviews for inappropriate content
or language and to verify that the
member had a visit with that provider. Non-members and providers can read the
reviews but cannot write them.
Physician Quality Measures
When searching for a primary care physician (PCP) through the Find a Doctor
tool, users can view up to 11 quality
measures in six categories with National Committee for Quality Assurance (NCQA)
benchmark comparisons for qualifying
PCP offices in the IBC network. The scores for these measures are calculated
based on data from our HMO/POS
population as a part of the Quality Performance Measurement (QPM) score program
portion of our Quality Incentive
Payment System (QIPS) program for PCPs.
The following measures will display within the Provider Profile page by
selecting the Physician Quality Measures tab:
- Asthma
— Use of appropriate medications for people
with asthma
- Cancer screening
— Breast cancer screening
— Cervical cancer screening
— Colorectal cancer screening
- Diabetes
— Retinal eye exam
— HbA1c testing
— LDL-C screening
— Medical attention for nephropathy
- Heart disease
— Persistence of beta-blocker treatment after a
heart attack
— Cholesterol screening for patients with
cardiovascular conditions
- Immunizations
— Childhood immunization: measles, mumps, and
rubella vaccine
- Women's health
— Breast cancer screening (same measure under
cancer screening)
— Cervical cancer screening (same measure under
cancer screening)
Peer comparisons are the NCQA Quality Compass Middle Atlantic HMO/POS 50th
Percentile for each measure.
Blue ribbon ratings have also been assigned based on the PCP's measure
performance relative to the NCQA Quality
Compass Middle Atlantic HMO/POS benchmarks:
- 1 blue ribbon: Score is < 25th percentile.
- 2 blue ribbons: Score is ≥ 25th percentile and < 75th
percentiles.
- 3 blue ribbons: Score is ≥ 75th
percentile.
PCPs without sufficient measure data will display the following messages in
place of measure scores and benchmarking:
- Not Enough Data to Report. Providers with low volume
(i.e., fewer than 30 members) for a particular measure.
- Does Not Apply to Physician Specialty. Providers for whom
measure does not apply to their specialty.
- Information Not Available. Providers who do not have
data, but the reason is unrelated to specialty applicability
of measure.
PCPs outside of IBC's Philadelphia five-county service area will also have
Physician Quality Measures displayed when
users select the National BlueCard® PPO network as their search
option. Users can view up to 20 measures in ten
different categories for these providers. This data is supplied by the Blue
Plan(s) contracted with each provider, and
information/links are available to learn more about those scores and
benchmarks.
Special recognitions
The Provider Profile page also displays special recognition given to PCP
offices:
- Patient-Centered Medical Home (PCMH). Indicators have been
added to applicable Provider Profile pages that
identify practices recognized by NCQA as a PCMH.
- Blue Physician Recognition (coming soon). An icon will
display for network PCP offices that have earned an overall
score (i.e., percentile rank in their specialty) in the Top 25th Percentile of
the QPM score program.
If you have any questions about the Find a Doctor tool, please call 1-800-ASK-BLUE.
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