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

See what we’re doing about coronavirus

With the spread of novel coronavirus in the U.S., we’re adapting for our members’ health. Here’s what you need to know.

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Quality Care Quarterly Newsletter

Learn how providers across Tennessee are creating successful quality practices, and get helpful tips and updates from our BlueCross quality teams.

Quality Care Initiatives

Quality Care Initiatives


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.

Quality Care Partnership Initiative (QCPI)

In 2015, BlueCross created the Quality Care Partnership Initiative (QCPI) in an effort to build a network of primary care physicians (PCPs) who are committed to quality, and agree to reimbursement that’s based on objective, measurable quality outcomes. QCPI is designed to improve the clinical quality, patient experience, and value of health care. Performance on these measures will influence the PCPs’ reimbursement for the next year.

Medical Home Partnership (MHP)

In 2009, BlueCross began working with primary care providers to implement the Patient-Centered Medical Home (PCMH) program. The PCMH model of care highlights the importance of the health care team and the patient's role in their own health. The goal is to improve coordination of care among the medical system, community, family and patient resulting in better outcomes and patient satisfaction.

Between 2009 and 2019, the BlueCross PCMH program emphasized chronic condition management and primary prevention. Building off the success of the PCMH program, BlueCross launched the MHP program in 2020. The MHP program continues to reinforce the value of care coordination, quality improvement and utilization management. Participating PCPs must meet certain performance standards including taking part in the Commercial Quality Care Partnership Initiative and maintaining a 3-star rating. They must also achieve NCQA PCMH Recognition and meet annual submission requirements.

Clinical Resources

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.