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S.C. doctors participate in quality ratings program

Staff Report
Published Nov. 8, 2012

Nearly 100 physicians in three medical groups across South Carolina have volunteered to have their doctors' quality of care ratings made available to BlueCross BlueShield of South Carolina members.

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 ratings will be viewable in the members' section of the company's website early next year.

"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, CEO of Palmetto Primary Care Physicians.

The data comes to BlueCross, with permission from the physician groups, from the Medical University of South Carolina's Outpatient Quality Improvement Network, or OQUIN. The network 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 Dr. Laura Long, BlueCross' vice president of clinical innovation and population health. "This means our members will have more information to help them make more informed decisions."

Other medical practices that want their quality ratings made available to BlueCross members may contact OQUIN to participate.

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 toward helping consumers consider costs as well as quality when evaluating health care options. The information also will be available to BlueChoice HealthPlan of South Carolina members and State Health Plan members.