Largest Initiative in California History to Measure Physician Performance Will Make Results Public

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Apr 19, 2010, 10:00 ET

"Blue Ribbon" recognition program will enable Blue Shield of California members to quickly find quality data about doctors online

SAN FRANCISCO, April 19 /PRNewswire-USNewswire/ -- For the first time, Californians will have access to information identifying physicians who scored highly on evidence-based performance measures under a new program announced today by Blue Shield of California and the Pacific Business Group on Health. The groundbreaking healthcare quality transparency initiative, which has widespread support from organizations ranging from AARP to CalPERS to SEIU, will allow the public to identify thousands of high-performing doctors online and to make more informed healthcare decisions.

PBGH, a business coalition of 50 purchasers, and not-for-profit health plan Blue Shield of California were brought together through the California Cooperative Healthcare Reporting Initiative (CCHRI), a collaborative of health care purchasers, consumers, health plans and physicians. The organizations worked together to measure the performance of 13,000 high-volume physicians on evidence-based healthcare quality standards. The Blue Ribbon Recognition Program will publicly recognize physicians who scored above average in up to eight measures in preventive screening, diabetes and other categories.

Beginning June 1, these physicians will have a blue ribbon icon added to their Blue Shield online profile, viewable at: www.blueshieldca.com/findaprovider. The program is based solely on data compiled to measure quality of care and does not consider cost information in any way.

The performance results are drawn from data collected by the California Physician Performance Initiative (CPPI), a multi-stakeholder initiative run by physician organizations, health plans, purchasers, consumers and health data experts to measure and report on the performance of California's physicians. Started in 2006 and run by CCHRI, CPPI aggregates claims data covering more than 5 million patients and 63,000 physicians to generate a reliable set of quality metrics.

"At PBGH we know that the doctor-patient relationship is at the core of our health care system," said David Lansky, Ph.D., president and CEO of the organization. "That's why the CPPI is so important to California's employers and families – to help patients make the best decisions about where to seek care. We hope that other plans will follow Blue Shield's lead in publishing information that enables Californians to make better decisions about healthcare for themselves and their families."

Michael-Anne Browne, M.D., Blue Shield of California's medical director for quality, added: "Californians currently have access to quality information on health plans, hospitals and even medical groups, but have virtually no quality information on their individual physician. That changes today, thanks to a diverse group of stakeholders who worked collaboratively to determine how the data should be collected, tallied, and responsibly reported to the public."

As part of the collaborative process that led to the blue ribbon program, Blue Shield network physicians received their preliminary quality results. All physicians were given an opportunity to review their own patient records and correct any deficiencies they believed to exist in the data. The physicians were taken at their word and the data were corrected when requested.

The following organizations commented about their support for the program:

AARP, the nation's largest membership organization for people 50+, believes the information will help empower patients. "AARP applauds this first step towards making physician performance information available to the public," said AARP California State President Jeannine English. "Choosing a doctor is one of the critical choices that consumers have to make. We believe that sharing performance information on doctors empowers patients to take a more active role in their health care and we encourage all health insurance plans to make physician performance information available to their members."

The California Public Employees' Retirement System (CalPERS) also sees the program as an important step in the right direction. "This is a valuable new tool that will help our members and employers make more informed health care decisions," said Priya Mathur, Chair of CalPERS Health Benefits Committee. "We support greater transparency in health care and this tool encourages accountability and higher quality by shining a spotlight on physician performance."

Terry Brennand, with the Service Employee International Union (SEIU) agrees. "SEIU has been a leader in the effort to improve our nation's healthcare system. We strongly support efforts that will provide our members with greater information about the quality of care physicians are providing. We commend Blue Shield of California for bringing physician specific quality information to our members. We are confident that greater transparency will not only allow our members to make more informed decisions about the care they receive, it will also create the right incentives for doctors to improve the care they provide."

The California Health Care Coalition (CHCC), a membership organization representing 4 million Californians, believes that the program will help both the public and physicians. According to Ken Stuart, CHCC's chairman and interim executive director, "Giving consumers much-needed performance information fosters accountability and encourages physicians to meet or exceed national standards of care."

The California School Employees Association (CSEA) also offered support. "CSEA has advocated for greater transparency of healthcare quality information for years," said legislative advocate Dolores Duran-Flores. "We are pleased to see that Blue Shield of California is bringing this information to the marketplace and to our members. With more information on the quality of care physicians provide, our members will be empowered to make the best decisions possible for their own care."

Barbara Decker, director of benefits for Southern California Edison, is looking forward to having this information easily accessible. "Blue Shield is to be applauded for taking this very important first step in providing consumers this valuable new tool," she said. "This will help bring greater transparency to the health care delivery system, while encouraging accountability and higher quality in physician performance.

George McGregor, fund administrator for the California Schools Voluntary Employees Benefits Association (VEBA), talked about consumer engagement. "It is imperative that we re-engage the consumer in making critical health care decisions," McGregor explained. "We strongly support Blue Shield and their efforts to communicate quality information in a useable, consistent format. Only through complete, consistent transparency and informed consumers can we increase the quality of the health care system."

More support came from Maurice Hodos, fund administrator for the UFCW National Health and Welfare Fund. "The UFCW National Health and Welfare Fund, as a participant of the California Health Care Coalition, strongly supports efforts to promote quality transparency in health care and the opportunity of our members to make health care decisions based on easily available informed quality information."

About Pacific Business Group on Health (www.pbgh.org)

Pacific Business Group on Health (PBGH) and its 50 major purchaser members

represent more than three million employees, retirees and their families, and billions in

annual healthcare expenditures. A non-profit established in 1989, PBGH partners with leading health plans, provider organizations, consumer groups and other stakeholders to promote higher value in health care.

About Blue Shield of California

Blue Shield of California, an independent member of the Blue Cross Blue Shield Association, is a not-for-profit health plan with 3.4 million members, 4,800 employees, and one of the largest provider networks; it offers a wide range of commercial and government products throughout the state. Blue Shield of California has contributed more than $120 million over the past four years to the Blue Shield of California Foundation -- which this year was named one of BusinessWeek's 20 most generous corporate foundations. Contact your local agent or broker for more information about Blue Shield products and services, or visit the Blue Shield web site at www.blueshieldca.com.