The Physician Alliance (TPA) recognizes the importance of collaboration between specialty practices and Patient Centered Medical Home primary care practices to improve care coordination and quality as defined by the Healthcare Effectiveness Data and Information Set (HEDIS) quality metrics. In order to encourage specialty physicians to implement and maintain specific Blue Cross Blue Shield of Michigan (BCBSM) Patient Centered Medical Home – Neighborhood (PCMH-N) capabilities that support neighborhood development and quality improvement, TPA developed two recognition awards for specialist:
Service Excellence Award in Care Coordination
Service Excellence Award for Quality Improvement
Achieving the Service Excellence Awards is important because the awards:
- Provide a mechanism for specialty practices to be recognized among their peers and their patients.
- Help identify potential areas of improvement in care coordination and quality improvement.
- Help guide practices to be successful in a rapidly changing healthcare environment.
- Will assist primary care physicians to easily identify those specialty practices who are excellent in care coordination and quality improvement processes.
SERVICE EXCELLENCE AWARD IN CARE COORDINATION
Specialty practices can earn the Care Coordination award star ratings based on meeting specific criteria, including achieving certain PCMH-N capabilities. The Care Coordination award is only available to specialty practices for which BCBSM PCMH-N capabilities apply. Not all specialty types can implement PCMH-N capabilities.
Practices that earn 4- or 5-star ratings in Care Coordination will be recognized among their peers and patients through listing on TPA’s website, signage to display in the practice, acknowledgement in TPA’s newsletter, and more. This information will also be shared with TPA primary care physicians.
SERVICE EXCELLENCE AWARD IN QUALITY IMPROVEMENT
Specialty practices that achieved the Service Excellence Award in Care Coordination and have HEDIS quality measures that apply to their specialty type can also work towards achieving the Service Excellence Award in Quality Improvement. Additional criteria apply, including meeting certain PCMH-N capabilities.
Practices that earn the Quality Improvement Award will be recognized among their peers and patients through listing on TPA’s website, signage to display in the practice, acknowledgement in TPA’s newsletter, and more. This information will also be shared with TPA primary care physicians.
HOW TO EARN STAR RATINGS FOR THE CARE COORDINATION AND QUALITY IMPROVEMENT AWARDS
The Service Excellence Awards will be announced annually using the BCBSM’s Physician Group Incentive Program (PGIP) Winter PCMH-N practice assessment and practice resource team assessment data. The awards will be announced in August of each year, starting in 2017.