In last month’s issue, my column outlined some of the ways we’re committed to ensuring that our members have access to high-quality, cost-effective healthcare. The importance of that commitment is demonstrated through our continued efforts to reward our primary care providers (PCPs) for their work improving healthcare quality and closing gaps in care. And one way we’re doing that is through our PCP Quality Incentive Program (PQIP).

Our 2019 PQIP booklet summarizes the program, which makes incentives available to PCPs who demonstrate support of quality improvements that are outlined by nationally recognized programs and measures, such as the Centers for Medicare and Medicaid Services (CMS) and the National Committee for Quality Assurance (NCQA). PCPs are uniquely positioned to affect improvement in many of the identified measures in this year’s program, specifically those related to closing gaps in care.

The 2019 program includes enhancements that address feedback we’ve received from providers in past years. For example, targets for Medicare Advantage measures will now align with the most current CMS Star Rating cut points, and Commercial measures will now align with the most current NCQA Quality Compass percentile benchmarks. Provider incentive payments will now be based on one overall composite achievement score rather than a measure-by-measure approach. The scoring methodology also now includes a Star rating, which will help you better understand your performance relative to your peers.

Worth noting is that BCBSRI has invested a total maximum amount of $9 million into the 2019 PQIP program, and providers who exceed their performance achievement scores may also be eligible for additional quality incentives. This further demonstrates our commitment to—and the importance of—improving the quality of care our members receive, and you play a critical role in making that happen.

Thank you for your continued partnership and support of the 2019 PCP Quality Incentive Program. If you have any questions or feedback, please contact your quality concierge team representative or email PQIP@bcbsri.org. We look forward to working together to continue improving healthcare quality and our members’ overall healthcare experience.