Quality ranking for primary care offices

September 30, 2020

Independence wants to recognize offices that have demonstrated a dedication to high-quality patient care by achieving the highest rank in quality of care for the HMO and/or PPO component of the Quality Incentive Payment System (QIPS) program, the Preventive and Quality Improvement Program (PQIP), or the Primary Care Advancement Model (PCAM) for measurement year 2019.

The quality program is a comprehensive ranking system of quality measures for primary care offices with 150 or more commercial HMO/POS and Medicare Advantage HMO members and/or 250 or more attributed commercial PPO members (including National BlueCard® PPO and Personal Choice® PPO members).

Performance measures

The programs’ ranking system is based on the Healthcare Effectiveness Data and Information Set (HEDIS®), a well-established and tested set of performance measures. The preventive health measures listed below are used as the baseline for measuring a provider's overall quality performance in comparison to their peers of the same specialty type:

  • childhood and adolescent immunizations;
  • childhood and adolescent well visits;
  • cancer prevention (screenings for breast, cervical, and colorectal cancers);
  • heart care (beta-blocker treatment after a heart attack);
  • asthma care (use of preferred medications for patients with chronic persistent asthma);
  • diabetic care (HbA1c control, eye exam rates, and nephropathy screening);
  • appropriate testing for children with pharyngitis;
  • avoidance of antibiotic treatment in adults with acute bronchitis;
  • appropriate treatment for children with upper respiratory infection;
  • rheumatoid arthritis care (disease-modifying anti-rheumatic drug therapy);
  • fracture care (osteoporosis management in women);
  • statin therapy (patients with cardiovascular disease or diabetes).

Congratulations to these primary care offices for demonstrating overall high quality in these measures and for achieving the highest rank in quality of care in 2020 (based on 2019 data) for the QIPS program, PQIP, or PCAM.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). Used with permission.