In another step toward transparency for the health care consumer, nearly 100 physicians in three medical groups across South Carolina have stepped up to have their doctors' quality of care ratings made available to BlueCross BlueShield of South Carolina members.
The ratings will be viewable in the members' section of the company's website early next year.
Initially, the quality ratings will focus on physicians who treat diabetes and will show how outcomes for all of their diabetes patients as an aggregate compare with outcomes of other doctors treating similar patients. Later rankings will expand to other chronic illnesses or health conditions.
The first physicians participating are from McLeod Family Medicine Residency Program, located primarily in the Pee Dee region; Palmetto Primary Care Physicians, located in five Lowcountry counties; and Spartanburg Regional Physician Group in the Upstate. The physicians treat a total of 150,000 patients.
The data comes to BlueCross, with permission from the physician groups, from MUSC's Outpatient Quality Improvement Network (OQUIN). OQUIN (http://academicdepartments.musc.edu/oquin), collects and compares the aggregate data.
Rating stars are assigned using the OQUIN comparison and nationally recognized standards. One star represents "below community standard," two stars represent "at community standard" and three stars represent "above community standard." The ratings will be updated annually.
"This is a program that physicians feel uses evidence-based and nationally recognized quality measures. Our program is voluntary, and we salute the early-adopter medical practices that are participating," said Laura Long, M.D., BlueCross' vice president of clinical innovation and population health. "This means our members will have more information to help them make more informed decisions."
"The entire health care spectrum is collaborating to improve the patient's experience and outcome. This initiative engages the consumer as well as the medical community and the payor," said William Hester, M.D., with McLeod Family Medicine Residency Program.
"Quality initiatives help physicians and consumers with information that ultimately supports the delivery and coordination of care. Performance measurement is critical to a high-functioning health care system," said Ron Piccione, Palmetto Primary Care Physicians' chief executive officer.
"Physicians value quality measurement as a means to continuous improvement. Transparency in health care helps everyone," said E. G. "Nick" Ulmer Jr., M.D., vice president of clinical Services, Spartanburg Regional Physician Group.
Brent Egan, M.D., senior medical director for OQUIN and professor at MUSC said, "OQUIN has served as a quality improvement partner for physicians and other providers for over a decade. We are pleased that OQUIN practices excel in providing high quality care for their patients."
Other medical practices that want their quality ratings made available to BlueCross members may contact OQUIN to participate at no cost. For more information about OQUIN, email Rob Davis at firstname.lastname@example.org.
This is part of an overall transparency program developed for BlueCross members. So far it includes a prescription drug cost comparison tool and hospital quality scores – all geared to helping consumers consider costs as well as quality when they evaluate their health care options. The information also will be available to BlueChoice HealthPlan of South Carolina members and State Health Plan members.
Headquartered in Columbia and operating in South Carolina for more than 65 years, BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association. The only South Carolina-owned and operated health insurance carrier, BlueCross BlueShield of S.C. comprises 47 companies involved in health insurance services, U.S. DoD health program and Medicare contracts, other insurance and employee benefits services, and a philanthropic foundation that funds programs to improve health care and access to health care for South Carolinians.