Transparent, Meaningful Physician Performance Metrics

BHIBlog

Blue Cross Blue Shield of Louisiana partners with BHI on provider reporting.

Last year, Blue Cross and Blue Shield of Louisiana (BCBSLA) set out to share actionable, credible, and accurate cost and quality reports with providers.

BHI has been partnering with the Plan since March 2020 to design and implement such reports for practitioners in BCBSLA’s Specialty Care Insights program.

In delivering enhanced “Provider Index” reports, BCBSLA utilizes BHI’s proprietary Episode of Care Grouper. Our grouper leverages National Data Warehouse data to analyze over 800 condition and treatment episodes, producing more clinically accurate and comprehensive comparisons.

Soon, BCBSLA and its providers will gain a transparent, 360º view of how similar practices in Louisiana and across the nation treat comparable patients for specific conditions.

External stakeholders have tested the reports. They say they greatly appreciate the interface’s simplicity and are thrilled by the greater amount of transparency and metric clarity.

The new BCBSLA Provider Index reports also include an interactive interface that allows internal users to perform further analysis and drilldowns.

Analytic possibilities include using BHI’s standardized pricing methodologies to review episode cost differences and calculate efficiency scores. Such calculations shed light on the degree to which provider variation is based on volume or contracted rates.

After the new BCBSLA Provider Index reports are introduced in early 2021, BHI and BCBSLA will use these analytic tools to examine the Plan’s value-based care arrangements and to further improve quality of care.