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Health Benchmarks(R) Selected As Enterprise Solution for Health Care Services Corporation

Posted on: Tuesday, 9 August 2005, 09:00 CDT

With the addition of Blue Cross and Blue Shield of Texas, the Health Benchmarks(R) Clinical Quality Indicators(TM) have become the enterprise solution for Health Care Services Corporation (HCSC) in measuring the relative quality of services delivered by physicians throughout their networks. Texas joins Blue Cross and Blue Shield of Illinois, where HCSC first implemented the Quality Indicators in 2004, and Blue Cross and Blue Shield of New Mexico, where the Quality Indicators were adopted earlier this year.

According to Antonio Legorreta, M.D., President and CEO, Health Benchmarks, "Using HBI's performance assessment methodology as the uniform approach within HCSC affords each of their plans the opportunity to compare performance system wide, which can lead to even greater quality improvements. Using the same measurements across all plans allows HCSC to comparatively benchmark levels of physician performance and insures consistency in the design and application of their pay-for-performance programs."

HBI's performance assessment methodology comprises an extensive inventory of over 90 evidence-based HBI Clinical Quality Indicators(TM) spanning a wide variety of physician specialty areas. HBI works closely with the individual health plans to define and select what metrics to use, and how best to adapt them to meet the specific needs of the plan, based upon their particular market, benefits structures, member demographics, and standards of care. Illinois and Texas are each using the same 28 Quality Indicators targeting several physician specialties, while New Mexico is employing a subset of 10 indicators in order to initially focus on primary care.

Besides giving valuable support to the plans when selecting and implementing the indicators, HBI also runs the metrics and reports the scores back to the plans. In addition to reporting the scores, HBI also provides the plans with benchmarking rates, both on the individual physician and plan level, that indicate how the physicians, as well as the plans, are ranked against others across the nation. The benchmarking rates derive from HBI's expansive data warehouse. The warehouse is one of the largest in the industry, covering over 20 million patient lives nationwide with history ranging from 3-6 years. Moreover, the data repository integrates data from numerous sources including inpatient and outpatient claims, employer data, pharmacy claims, membership and demographic data, carve-out vendor data (e.g. mental health), financial data, laboratory values, and survey data.

Health Benchmarks(R) Inc. (HBI) is an applied health services research company that specializes in transforming healthcare data into meaningful, actionable information for managed care organizations, pharmaceutical companies, large employers, and other health services organizations. Utilizing the company's analytical assets, HBI conducts complex health outcomes research and analysis to facilitate evidence-based decision-making in an increasingly competitive marketplace. HBI is an industry leader in the development of physician and hospital pay-for-performance programs, and delivers real-world business solutions that drive and sustain high quality and value in the healthcare industry. Please visit www.healthbenchmarks.com or call 1-800-465-6575 for more information.

Source: Business Wire

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