Products & Programs Long-Term Services & SupportsCommercialSeptember 1, 2024

The Power of the Blues introducing the Blue National Physician Performance Dataset

Anthem is excited to announce the development of the Blue National Physician Performance Dataset. This initiative is a collaborative approach between Blue Cross Blue Shield Association (BCBSA), Blue Health Intelligence (BHI), and Motive Medical Intelligence (MMI) to develop a consistent national approach to evaluating physicians at the NPI level that incorporates measures of quality of care, appropriateness of care, and cost/efficiency of care.

Effective January 1, 2025, Anthem may incorporate The Blue National Physician Performance Dataset in various ways, including, but not limited to:

  • Special opportunities to participate in product offerings.
  • When members contact Anthem with requests for referral options.
  • Developing provider designations in provider directory (FindCare) tools.
  • Enhancing existing tools in FindCare and Cost Finder such as Personalized Match that assist members with identifying or sorting providers.

 For more information on how physicians are evaluated within each of the three categories (quality of care, appropriateness of care, and cost/efficiency of care), you can view the Blue National Physician Performance Dataset Evaluation Method.

If you have any questions about the Methodology or your score, contact your local provider relationship management representative.

Anthem Blue Cross and Blue Shield is the trade name of Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

COBCBS-CM-061371-24-CPN57527, COBCBS-CM-061576-24-CPN57527

ATTACHMENTS: Blue National Physician Performance Dataset Evaluation Method (pdf - 0.11mb)

PUBLICATIONS: September 2024 Provider Newsletter