In spring 2019, BCBSRI launched the PCP performance ratings program to highlight strong performing providers consistently delivering lower costs and higher quality through care that is patient-centered, evidence-based, appropriate, and coordinated. The ratings provide consumers with a new perspective on a PCP’s overall healthcare cost and their ability to consistently adhere to clinical best practices per standardized metrics.

PCP performance ratings are updated on an annual basis and the 2020 PCP performance ratings will be available on the BCBSRI Find a Doctor tool in mid-May. Members can view the ratings after logging on to the member portal.

Reviewing your performance rating

As a primary care provider, if you have a concern about your performance rating, you can request a formal review and share any new data that may add to the accuracy of the measurement process. Please submit that information to ProviderRequests@bcbsri.org.

The BCBSRI Network Performance Team is available as a resource to help you identify opportunities for improvement and understand the PCP performance ratings. The BCBSRI Quality Concierge program has a team of dedicated nurses that can provide additional education on the PCP Quality Incentive Program (PQIP), help identify current gaps in care, and identify areas of opportunity within each defined measure.

Please contact ProviderRequests@bcbsri.org for questions, requests for additional support from the above mentioned teams, or rating review requests.