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Anthem Blue Cross and Blue Shield Introduces 'Quality-In-Sights(R)' Primary Care Incentive Program to Improve Quality and Safety of Patient Care
Date:10/6/2009

DENVER, Oct. 6 /PRNewswire/ -- Anthem Blue Cross and Blue Shield ("Anthem") announced today the launch of its 2009 Quality-In-Sights® Primary Care Incentive Program. The program is designed to evaluate and financially reward performance by eligible primary care physician group practices that meet identified industry measures of quality, appropriate pharmaceutical utilization, identified external recognitions and technology adoption aimed at enhancing patient care.

"As health care reform is debated, several solutions have been identified as being critical to its success -- improving the quality and safety of medical care is one of the essentials," said Dr. Art Jones, medical director, Anthem Blue Cross and Blue in Colorado. "Thirty percent of health care spending - estimated at $700 billion a year - is spent on tests, treatments and procedures that may provide no value and may actually harm patients. When physicians practice 'evidence-based' medicine we can be assured that patients are getting the kind of care they need and deserve. Anthem's Quality-In-Sights® program expands on Anthem's long history of commitment to improving the quality and safety of care for its members."

The program includes participating physicians who meet specific eligibility requirements and who specialize in and have designated their primary specialty as, internal medicine, family practice or pediatrics. The measurement period for the program will begin on November 1, 2009 through October 31, 2010. The measures used are a combination of chronic disease, prevention measures, measures focused on pharmacy utilization, and technology adoption. The 2009 measures focus on chronic diseases: diabetes, asthma, coronary artery disease and primary preventative: childhood and adolescent immunizations and well care visits. Qualifying physicians' practices will be rewarded through an adjustment to designated compensation beginning July 1, 2011 through June 30, 2012.

Anthem Blue Cross and Blue Shield and its parent company has been an industry leader in linking quality performance to their provider network for reimbursement. Their first pay for performance and improvement program was introduced in 2004 as Promoting Healthcare Quality Program (PHQ). The program was revamped in 2007 to encompass national quality initiatives, clinical improvement collaborations, and the adoption of technology. The Pulse program was then piloted in 2008 to physicians who met eligibility requirements and specialized in internal medicine, family practice, general practice or pediatrics. Anthem Blue Cross and Blue Shield in Colorado was the first Colorado health plan to introduce a hospital Improving Health Care Quality program in 2005.

"Physicians want to provide the highest quality possible, but no one plays a game well if he can't see the scoreboard. Programs like Anthem's give us tangible feedback tied to some of the funding necessary to build the systems to manage our performance," said Dr. Jay Want, president and CEO, Physician Health Partners.

"We're very pleased that the majority of Colorado Primary Care Physicians have partnered with us in this effort to improve the safety and quality of health care," said John Martie, president, Anthem Blue Cross and Blue Shield in Colorado. "We are fortunate to live in a state with some of the best primary care physicians in the country. I commend these providers who have decided to partner with us for the Quality-In-Sights program. It's a tangible example of their commitment and willingness to do all they can to provide quality care for their patients."

About Anthem Blue Cross and Blue Shield in Colorado

Anthem Blue Cross and Blue Shield is the trade name of Rocky Mountain Hospital and Medical Service, Inc., an independent licensee of the Blue Cross Blue Shield Association. (® )ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Colorado is available at www.anthem.com.

SOURCE Anthem Blue Cross and Blue Shield in Colorado


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SOURCE Anthem Blue Cross and Blue Shield in Colorado
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