As a provider in the BlueCare Tennessee network, we trust you. We know that you know how to take care of your patients. Our quality campaigns, tip sheets and clinical information are not intended as medical advice or direction for the care you provide, but to show you the best way to document care for the claims you submit based on your patients’ conditions.
Improving the health of your patients and our members is a goal we share and we intend to work with you toward meeting and exceeding national standards of health care for them. Our standard of quality is set by the National Committee for Quality Assurance (NCQA) and is followed by more than 90 percent of the country’s health plans.
NCQA evaluates health plan performance with the Healthcare Effectiveness Data and Information Set – better known as HEDIS. Our HEDIS scores are a measure of how well providers in the BlueCare Tennessee networks deliver care to members based on several factors, including: effectiveness of care, ease of access and patient experience.
The State of Tennessee launched the Tennessee Health Care Innovation Initiative (THCII) to help improve the health of Tennesseans and address health care spending by changing the way health care is paid for in Tennessee.
Best-practice guidance and coding tips for each of the quality measures: