QUALITY CARE INITIATIVES

Working Together to Provide the Highest Level of Care

We know you’re committed to providing quality care to your patients. Here’s the information you need to help maximize your performance in our quality programs.

Child giving doctor high-five | BCBS of Tennessee Child giving doctor high-five | BCBS of Tennessee Child giving doctor high-five | BCBS of Tennessee

Quality Care Initiatives

Quality Care Initiatives

Commercial

Quality Partnership

We value your partnership in Commercial Quality Improvement. To keep you informed of changes and support your success, we provide a variety of publications, services and events. The Quality Care Measures & Comprehensive Program Information Guide includes information and tips to help you close HEDIS® measures for your patients. It also includes quick references, detailed clinical resources and overviews of other resources we offer.

Clinical Resources

Antibiotic Stewardship Resources

Explore the CDC training on antibiotic stewardship to gain insights on appropriate use and managing patients’ expectations. Additional resources and patient education can be found within the training, and free CEUs are also available.

Immunizations for Adolescents (IMA) Resources

Medicare Advantage

Quality+ Partnership Program

We know you’re working hard to help our members get preventive screenings, effective treatment and improved access to necessary health services. We’re here to support and reward your efforts in providing quality, value-based care. Our Quality Program Information Guide includes a Quality+ Partnerships Program Overview for BlueAdvantage PPO and BlueEssential HMO SNP, important information about the current Quality Amendment Measures, and details about other resources available to you.

Quality+ Partnership Program


Risk Adjustment Guides


Pharmacy Guides

 

Support Programs

BlueCare Tennessee

Quality Initiatives

We appreciate your participation in our BlueCare Tennessee Quality Initiative programs. The Quality Measures Booklet features everything you need to know to maximize your performance for each quality measure. You'll also find information about the state's THCII program below. 

BlueCare Plus

Quality+ Partnership Program 

Since BlueCare Plus serves the needs of Medicare members who also qualify for Medicaid, it offers providers the same Quality+ Partnership program as Medicare Advantage. The Quality Program Information Guide provides comprehensive information about quality measures for your BlueCare Plus and BlueCare Plus Choice patients.

Clinical Resources

Medical staff member applies bandage to their patient's wrist Medical staff member applies bandage to their patient's wrist

Tennessee Health Care Innovation Initiative (THCII)

Led by the state of Tennessee, THCII was created to lower costs and improve health care for Tennesseans. The program is designed to shift the health care system from volume-based to value-based, while protecting our members' physical and financial health by reducing ineffective or inappropriate treatments. In turn, doctors and hospitals are rewarded for delivering high-quality, efficient medical care.

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BlueCross Performance Rating

Rating system for Commercial Network Primary Care Providers

The BlueCross Performance Rating helps our members compare primary care providers by objectively rating how well they meet recognized health and wellness standards, deliver efficient care and manage patients' total health.