BCBSM/BCN recently released the quality measure changes for program year 2019 for their incentive programs. The following measures were added to each respective program:
BCBSM Clinical Quality Initiative, PCMH, & Clinical Quality Value-Based Reimbursement added measures:
- childhood immunization status – combo 10
- statin therapy for patients with cardiovascular disease – statin therapy (part C SPC)
- statin therapy for patients with diabetes – therapy (SP)
Performance Recognition program quality measure changes:
- BCN commercial measures removed:
- weight assessment and counseling for nutrition and physical activity – counseling for physical activity
- weight assessment and counseling for nutrition and physical activity – counseling for nutrition
- childhood immunization status – influenza
- BCN commercial measures added:
- childhood immunization status – combo 10
- cervical cancer screening
- medication management for people with asthma – 75 percent
- controlling high blood pressure
- statin therapy for patients with cardiovascular disease – statin therapy
- antidepressant medication management – effective continuation phase treatment
- Medicare Advantage (BCNA/MAPPO) measures removed:
- Medicare Advantage measures added:
- statin therapy for patients with cardiovascular disease – statin therapy (part C SPC)
- statin therapy for patients with diabetes – therapy (SPD)
BCBSM/BCN incentive program’s quality measures are similar to those of the Patient-Centered Medical Home program, for which Beaumont ACO provides quarterly scorecards for practices to monitor their progress. Beaumont ACO program coordinators will be meeting with practices in the first quarter of 2019 to further discuss the new 2019 measure changes and how practices can improve their performance. Resources and tools will be shared with physicians and staff during those meetings.