BCBSRI to add PCP scores for cost efficiency and quality in its doctor-finding tool

BLUE CROSS & BLUE SHIELD of Rhode Island is adding PCP performance ratings to its online Find a Doctor tool based on quality of care and cost efficiency.
BLUE CROSS & BLUE SHIELD of Rhode Island is adding PCP performance ratings to its online Find a Doctor tool based on quality of care and cost efficiency.

PROVIDENCE – Blue Cross & Blue Shield of Rhode Island is adding primary care performance ratings for in-network doctors to its online “Find a Doctor” tool, the health insurance company announced Thursday.

The ratings will be based on quality of care and cost efficiency, BCBSRI said. Quality will be based on how often patients are successfully treated and how often PCPs perform preventative screenings for diseases such as breast cancer and diabetes.

Cost efficiency will be based on an average cost-per-patient, adjusted for the health mix of patients a provider treats.

The scores will be represented as scores from 1-5, with 5 being a top performing doctor for both cost efficiency and quality, as defined by BCBSRI. Doctors with insufficient data will not have a score.

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“Primary-care providers play a critical role in keeping patients healthy given their unique vantage point of seeing the full picture of their patients’ health,” said Kevin Splaine, BCBSRI executive vice president of care integration and management. “Patients should feel empowered to choose a provider who has a proven track record of performance, in addition to weighing other details that matter to them, whether it be their location, the language they speak or recommendations from friends and family.”

“We’re hoping that by breaking down barriers and promoting transparency and accessibility, patients will feel a type of ownership or relationship with their PCPs, thinking of them as ‘their’ doctor or nurse practitioner,” said Dr. Matt Collins, BCBSRI vice president of clinical integration.