The program has several levels for the physician to work through. In the first phase, Highmark offered the physicians a pre-survey allowing them to examine their practice patterns and how they manage the care of patients with chronic conditions.
After the survey was completed, Highmark's medical management consultants reviewed the results with the physicians to develop strategies to correct any gaps that were identified to help ensure the providers satisfy the NCQA standards.
In the second phase, a physician completed the NCQA application and workbook or survey tool based on the practice patterns for all the physicians' patients. In the final level, the physician received financial reimbursement from Highmark when the certification was awarded to the provider.
"This initiative provides an excellent framework for physicians, staff, and patients to work together to improve the health of patients with diabetes. We feel strongly that this ongoing collaborative effort has improved the care of our patients," said Gregory Walker, M.D., Internal Medicine Specialists, Aliquippa.
The 433 network physicians that have completed the program have the potential of improving care for about 55,000 Highmark members with chronic conditions from the practices that participated.
Highmark launched the certification pilot program in January 2007 and during the next two years Highmark will evaluate the program's effectiveness in improving care and reducing costs.
About Highmark Inc.
As one of the leading health insurers in Pennsylvania, Highmark Inc.'s mission is to provide access to affordable, quality health care enabling individuals to live longer, healthier lives. Based in Pittsburgh, Highmark serves 4.6 million people through the company's health care benefits business.
Highmark contributes millions of dollars to help keep quality health
care programs affordable and to support community-based prog
|SOURCE Highmark Inc.|
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