What does physician, clinic, or group clinical performance measure?
Clinical performance measures how often patients of a doctor, other health professional (e.g., physician assistant, advanced registered nurse practitioner or other provider licensed to provide a specific medical service) or medical group at a clinic received the recommended care for a specific condition. These results are then compared to the typical or average performance of other health care professionals in the local area. The performance score is often the result of connecting patient care data from medical claims to a doctor or other health professional, sometimes grouping it by clinic or group practice, and analyzing the data using accepted standards of care. The performance results are provided to the doctors, health professionals and clinics or groups to support improvement of medical care. The Blue Physician Clinical Performance Measurement Program is based on a subset of the Healthcare Effectiveness Data and Information Set (HEDIS®) Physician Measures, a widely-accepted and n
