THOUSAND OAKS, Calif., July 7 /PRNewswire/ -. Blue Cross of California (Blue Cross) today announced its HMO Quality Scorecard award recipients for calendar year 2004. One hundred and ninety six participating physician groups throughout the state were paid an incentive amount totaling $72 million using Blue Cross’ Quality Scorecard and other applicable contract requirements, which were first implemented in July of 2001. Camino Medical Group located in Northern California was identified as Blue Cross’ top performing physician group for their scorecard achievements in 2004. Facey Medical Group of Los Angeles was the top performer in Southern California.
“It’s very exciting for us to see this program grow in success and reward our physician partners for improving their quality and enhancing patient service throughout the state,” said Dr. Michael Belman, staff vice president and medical director, Blue Cross of California. “We are seeing our members and patients benefiting from care that is quality driven. Since introducing this program the performance level of the physician groups has improved significantly.”
In 2001, Blue Cross implemented a new Quality Scorecard for its HMO medical groups based on feedback from physician partners and the endorsement of its external Physician Relations Committee. The evaluation process began monitoring physician groups for improving the quality of care given to HMO patients using health outcomes and patient satisfaction information from a number of clinical and service categories. The quality measures include patient satisfaction surveys, clinical measures, waiting times for appointments, number of complaints and grievances, and review of medical group or IPA functions. Performance in managing chronic diseases such as asthma and diabetes and adherence to screening guidelines for breast, and cervical cancer were some of the clinical measures tracked.
“Employers see the need for differential payments based on providers’ performance as a central element that must be built into the health care system,” said Peter Lee, President and CEO of the Pacific Business Group on Health. “Blue Cross’ program is important both because it is one of the largest payment programs in the country, but also because these payments go hand-in-hand with using many standard measures that have been developed in collaboration with both medical groups and other health plans as part of the Integrated Healthcare Associations Pay-for-Performance initiative.”
Blue Cross of California’s revised Quality Score Card has been implemented continuously since July 2001. As contracts are renegotiated with each medical group in its HMO network, their bonuses are tied to the new criteria. Out of a total 196 medical groups contracted with Blue Cross throughout the state, more than 176 of them were eligible under the new criteria in 2004.
Blue Cross of California is one of the state’s largest health insurers and together with its California affiliates, the company serves more than 7.6 million medical members. Headquartered in Southern California, Blue Cross of California offers a flexible product portfolio with a broad range of options for small, medium and large groups, as well as individual plans for people without access to group coverage, seniors and consumers who are eligible for state sponsored programs. Blue Cross of California is an independent licensee of the Blue Cross Association and can be found on the web at www.bluecrossca.com.
Blue Cross of California
CONTACT: Kellie Bernell, +1-805-557-6755, Kellie.Bernell@wellpoint.com,for Blue Cross of California
Web site: http://www.bluecrossca.com/
