Living Well


BlueCross Offers Physician Quality And Cost Information To Members

Tuesday, September 16, 2008

BlueCross BlueShield of Tennessee announced that physician-specific information on clinical quality and health care costs is now available to nearly two million Tennesseans at bcbst.com.

The BlueCross Physician Quality and Cost Transparency program responds to increasing consumer demand for more information about the quality of health care and cost as an increasing number of Tennesseans embrace popular health insurance benefit plans such as Health Savings Accounts, Health Reimbursement Arrangements and Flexible Spending Accounts.

A recent study in the US News and World Report indicated that 82 percent of Americans are dissatisfied with the U.S. health system and 90 percent said that they supported efforts to improve health care quality, cost and access.

"Our members and employer groups have been very specific in their requests for physician-specific cost and clinical quality information," said Linda Andreae, senior vice president and chief marketing officer for BlueCross. "We've made this tool a priority as we enhance our already industry-leading consumer health tools available at bcbst.com."

The online tool will include information on how much individuals can expect to pay for treatment of certain illnesses and physician quality ratings based on whether patients received the treatments or tests required for certain conditions.

HealthCare 21 President and CEO Jerry Burgess said, "In America, we make buying decisions based on value, a combination of quality and price of a product or service. Health care is not an exception. If we want a better health care system and affordable prices, then what BlueCross has done is a step in the right direction."

HealthCare 21 is a nonprofit coalition of organizations committed to improving health care in Tennessee.

Cristie Upshaw Travis, CEO, Memphis Business Group on Health said, "Research over the past decade has clearly shown there is significant variation in the practice of medicine for physicians. Frankly, some physicians do a much better job in delivering quality of care and reasonably priced care than others. It is our position the consumer has a right to know the quality and price of services offered by physicians so that the consumer can be well informed."

The Memphis Business Group on Health is also a nonprofit coalition of organizations committed to improving health care in Tennessee.

BlueCross has worked closely with the physician community to create a claims-based tool that reflects the practice standards of physicians across the state in regard to Healthcare Effectiveness Data and Information Set-based quality measures.

BlueCross also established a Physician Advisory Panel, consisting of doctors from across the state of Tennessee, to consult with and advise about all aspects of the quality and cost program during its development.

Several consumer focus groups were also held to be certain the information was relevant to Tennesseans.

The program uses eight different quality measures based on nationally recognized guidelines for effective care, with guidelines endorsed by the National Committee for Quality Assurance and other independent national organizations. The tool also includes Board Certification information for specific physicians, and median costs per episodes for specific conditions. The NCQA is a private, not-for-profit organization dedicated to improving health care quality.

On BlueAccess, the secure area of bcbst.com, members can use the tool to view results of eight clinical quality indicators that evaluate the appropriate use of basic screening tests. The eight quality measures are:
1. Glycosylated hemoglobin (HBA1C) test for diabetes
2. LDL monitoring for diabetics
3. Diabetic retinal exam
4. Monitoring for diabetic nephropathy
5. Chlamydia screening for women
6. Colorectal cancer screening
7. Mammography screening
8. Cervical cancer screening

The Physician Quality and Cost tool joins BlueCross' other online consumer tools, such as the hospital quality comparison tool, the dental cost estimator tool and the treatment cost estimator, among many others that are available to BlueCross members on bcbst.com.


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