Health Groups, CMA at Odds Over Blue Ribbon Quality Reporting Plan
Yesterday, Blue Shield of California and the Pacific Business Group on Health announced a new program called the Blue Ribbon Recognition initiative that aims to provide California consumers with more data on physician quality performance, the San Francisco Business Times reports (Rauber, San Francisco Business Times, 4/19).
The same day, the California Medical Association withdrew its participation from the project, citing concerns that the rating system could provide patients with inaccurate and misleading information (Clark, HealthLeaders Media, 4/20).
Blue Ribbon Project Details
Under the Blue Ribbon project, physicians that score above average on up to eight quality measures can add a blue ribbon icon to their Blue Shield online profile. Scores are based on quality measures and do not account for the cost of care.
The project is slated to go public on June 1 (Goedert, Health Data Management, 4/19).
Blue Shield and PBGH teamed up for the project with support from the California Cooperative Healthcare Reporting Initiative.
The organizations developed a plan to evaluate the performance of 13,000 high-volume physicians using quality data collected by the California Physician Performance Initiative. CCHRI runs CPPI, which generates quality metrics by aggregating claims data covering more than five million patients and 63,000 physicians.
Some of the organizations supporting the Blue Ribbon project include:
- The California Public Employees' Retirement System;
- The California School Employees Association;
- The California Schools Voluntary Employees Benefits Association;
- The Service Employees International Union; and
- The UFCW National Health and Welfare Fund (San Francisco Business Times, 4/19).
CMA previously worked with PBGH and other health groups to develop the Blue Ribbon project.
However, the organization terminated its participation in the effort because it said the rating system could score physicians based on irrelevant billing data and might encourage doctors to order repeat tests.
In a previousÂ letter to Blue Shield and PBGH officials, CMA also expressed concern that:
- The rating system could encourage physicians to turn away noncompliant patients;
- Inaccurate data used by CPPI could mislead patients;
- The patient sample size is too small;
- The project does not sufficiently take physicians' recommendations into account; and
- The quality metrics do not provide adequate information on patient outcomes.
Blue Shield Response
Meredith Mathews, Blue Shield's chief medical officer, defended the quality reporting system in a letter to CMA CEO Dustin Corcoran.
Mathews wrote that the claims data provide reliable quality information, adding that physicians can correct data before they are published (HealthLeaders Media, 4/20).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.