Blue Cross Blue Shield Axis® Provider Insights (Provider Insights1) is a national dataset that enables plans to report on measures of quality, appropriateness, and cost/efficiency nationally at the individual NPI level.
This dataset is a compilation of claims and quality data developed through a partnership with the Blue Cross Blue Shield Association, Blue Health Intelligence 2, and Motive Medical Intelligence.3
- Draws from Motive Medical Intelligence for quality and appropriateness insights and from Blue Health Intelligence for cost/efficiency.
- Evaluates performance for individual physicians across the following 20 specialties, including primary care, which represents approximately 60% of total medical spend.
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Using this dataset, along with Blue Cross Blue Shield of Massachusetts data, we are placing PCPs and specialists into three performance categories.
- Category 1 providers: Scored best on a combination of quality, appropriateness, and cost/efficiency of care.
- Category 2 providers: Scored in the middle range of performance.
- Category 3 providers: Scored lower on cost/efficiency of care or scored lower on quality of care and appropriateness of care.
Blue Cross Blue Shield of Massachusetts will use these categories in the development of new and evolving products and solutions.
Providers in the 20 specialties listed above can log in to view our Performance Category Methodology.
A: Providers are placed into one of three categories based on their overall performance compared to other providers nationally in the same specialty.
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Scored best on a combination of quality of care, appropriateness of care, and cost/efficiency of care. |
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Scored in the middle range of performance. |
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Scored lower on cost/efficiency of care or scored lower on quality of care and appropriateness of care. |
Providers in one of the 20 specialties listed above can log in and refer to the Performance Category Methodology document for definitions of appropriateness of care, quality of care, and cost/efficiency of care.
A: The dataset will be refreshed annually and we will make updates to the categories as appropriate. We anticipate that the categories will be updated the following January 1.
A: Not at this time. In the future, we expect to list providers in provider directories.
1. Blue Cross Blue Shield Axis (BCBS Axis) Provider Insights was developed in partnership with the Blue Cross Blue Shield Association, Blue Health Intelligence, and Motive Medical Intelligence.
2. Blue Health Intelligence® (BHI®) is a company that provides analytic intelligence information tailored to the Blue system that helps Blue Plans improve health care access, equity, and affordability. Privately owned by the Blue Cross Blue Shield Association (BCBSA) and 17 of the nation’s Blue Plans, BHI is focused on using the Blue systems’ collective data assets to provide measurable impact to Plans nationwide. Visit bluehealthintelligence.com to learn more.
3. Motive Medical Intelligence is a company that provides analytics solutions to help health plans with insights on cost/efficiency and quality of care. Visit motivepw.com to learn more.
