© 2011 Blue Cross and Blue Shield of Minnesota. All rights reserved. PHYSICIAN QUALITY MEASUREMENT PROGRAM (PQM)

Patient Review of Physicians Physician Quality Measurement Blue Physician Recognition 2 BLUE SOLUTIONS: TRANSPARENCY SOLUTIONS Blue Cross Blue Shield of Minnesota (Blue Cross) is launching Physician Quality Measurement (PQM) as one of three key initiatives to support consumer transparency. Members search for quality healthcare information online. Displays physician performance information to assist members in selecting a doctor.

Blue Cross is launching an online capability that displays physician performance measures to help members select a doctor. 3 PHYSICIAN QUALITY MEASUREMENT: OVERVIEW Overview Physician performance measures are based on nationally endorsed and evidence- based HEDIS measures that align with industry and federal health care reporting and quality improvement programs. Blue Cross will be providing the following measures Appropriate Testing for Children with Pharyngitis, Appropriate Treatment for Children with Upper Respiratory Infection, Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis, Breast Cancer Screening, Cervical Cancer Screening, Childhood Immunization: chickenpox (VZV) vaccine, Childhood Immunization: measles, mumps and rubella vaccine, Chlamydia Screening Blue members will be able to view and learn about physician performance results in our provider finder tool as well as on the Blue National Doctor & Hospital Finder on bcbs.com.Blue National Doctor & Hospital Finder Easy-to-understand performance symbols will indicate whether the performance of a physician or group practice is above, comparable to or below what is expected locally.

A subset of HEDIS measures were chosen based on high-impact metrics that have statistically valid results and correlate with outcomes. 4 PHYSICIAN QUALITY MEASUREMENT: HOW IT WORKS

Performance Ratings A three-star rating communicates if physicians or professional providers are rated as below (1 star), meets (2 stars) or exceeds (3 stars) local benchmarks. The selected PQM measures help Blue members understand how their doctor performs compared to local norms. 5 PHYSICIAN QUALITY MEASUREMENT: HOW IT WORKS Note: Functionality views are illustrative. These scores are based on locally calculated measures and comparisons. Rating Patients Treated Per Guidelines 7 of 24 = 29% Local Comparison 40% Rating Patients Treated Per Guidelines 20 of 24 = 83% Local Comparison 87% Rating Patients Treated Per Guidelines 21 of 24 = 88% Local Comparison 81%

PQM is the basis of practice improvement efforts and highlights the commitment of a physician or group practice to provide safe and evidence-based care. 6 PHYSICIAN QUALITY MEASUREMENT: BENEFITS Physician Quality Measurement will… … engage and empower consumers to make informed healthcare decisions and assume an active role in managing care for themselves and their families. … complement your practice improvement efforts and highlight your commitment to providing safe, effective and patient-centered care in your community. …work toward improving care through measuring what can be measured, promoting ongoing practice improvement and recognizing you as a champion of care delivery.

© 2011 Blue Cross and Blue Shield of Minnesota. All rights reserved.