As previously communicated, we recently launched an enhanced version of our Find a Doctor tool that is available on the IBC website. Below is additional information about the new features that are now available through this tool.

Patient experience reviews for facilities

Member-submitted experience reviews for network facilities can be viewed on the Find a Doctor tool. The questions are similar to those asked in the Healthcare Providers and Systems (HCAHPS) survey and cover topics such as:

• Overall experience and recommendation
• Provision of follow-up care instructions
• Physician and staff communication
• Cleanliness and restfulness of environment
• Food quality
• Maintenance of privacy and dignity

These reviews can be submitted only by members who log on through our secure member website. A comprehensive process is in place to moderate all submitted reviews for inappropriate content or language and to verify that the member had a visit with that provider. Non-members and providers can read the reviews but cannot write them.

Physician Quality Measures

When searching for a primary care physician (PCP) through the Find a Doctor tool, users can view up to 11 quality measures in six categories with National Committee for Quality Assurance (NCQA) benchmark comparisons for qualifying PCP offices in the IBC network. The scores for these measures are calculated based on data from our HMO/POS population as a part of the Quality Performance Measurement (QPM) score program portion of our Quality Incentive Payment System (QIPS) program for PCPs.

The following measures will display within the Provider Profile page by selecting the Physician Quality Measures tab:

• Asthma
  — Use of appropriate medications for people with asthma
• Cancer screening
  — Breast cancer screening
  — Cervical cancer screening
  — Colorectal cancer screening
  
• Diabetes
  — Retinal eye exam
  — HbA1c testing
  — LDL-C screening
  — Medical attention for nephropathy
  
• Heart disease
  — Persistence of beta-blocker treatment after a heart attack
  — Cholesterol screening for patients with cardiovascular conditions
  
• Immunizations
  — Childhood immunization: measles, mumps, and rubella vaccine
  
• Women's health
  — Breast cancer screening (same measure under cancer screening)
  — Cervical cancer screening (same measure under cancer screening)
  

Peer comparisons are the NCQA Quality Compass Middle Atlantic HMO/POS 50th Percentile for each measure.

Blue ribbon ratings have also been assigned based on the PCP's measure performance relative to the NCQA Quality Compass Middle Atlantic HMO/POS benchmarks:

• 1 blue ribbon: Score is < 25th percentile.
• 2 blue ribbons: Score is ≥ 25th percentile and < 75th percentiles.
• 3 blue ribbons: Score is ≥ 75th percentile.

PCPs without sufficient measure data will display the following messages in place of measure scores and benchmarking:

• Not Enough Data to Report. Providers with low volume (i.e., fewer than 30 members) for a particular measure.
• Does Not Apply to Physician Specialty. Providers for whom measure does not apply to their specialty.
• Information Not Available. Providers who do not have data, but the reason is unrelated to specialty applicability of measure.

PCPs outside of IBC's Philadelphia five-county service area will also have Physician Quality Measures displayed when users select the National BlueCard^® PPO network as their search option. Users can view up to 20 measures in ten different categories for these providers. This data is supplied by the Blue Plan(s) contracted with each provider, and information/links are available to learn more about those scores and benchmarks.

Special recognitions

The Provider Profile page also displays special recognition given to PCP offices:

• Patient-Centered Medical Home (PCMH). Indicators have been added to applicable Provider Profile pages that identify practices recognized by NCQA as a PCMH.
• Blue Physician Recognition (coming soon). An icon will display for network PCP offices that have earned an overall score (i.e., percentile rank in their specialty) in the Top 25th Percentile of the QPM score program.

If you have any questions about the Find a Doctor tool, please call 1-800-ASK-BLUE.