Collaboration on Quality®

Primary Care Program

Wellmark's Collaboration on Quality® Primary Care Program recognizes participating primary care clinicians in Iowa and South Dakota who provide care in line with nationally recognized measures of care.

 

Program participants have agreed to share their performance information with members, employers, and other providers. This information is found in Wellmark’s online directory.

 

Clinicians who meet performance levels for program components are eligible for special recognition, including potential financial rewards.

 

Please note: Although these participants have met the program criteria, this does not imply any guarantee of positive outcome or endorsement by Wellmark. In addition, coverage for services provided by a clinician to satisfy program measures is determined by the terms of each member’s coverage manual or policy.

Primary Care Program Performance Level Descriptions

Performance levels are based on the performance of the clinic rather than the individual clinician:

                                            

Level 1:  This clinic has achieved the baseline performance level for this measure.

                                                                                                      

Level 2:  This clinic exceeds Level 1 performance for this measure.

 

Level 3:  This clinic meets the highest program performance levels for this measure.

 

Clinics achieve level 1, 2, or 3 based on their average performance using the measures and outcomes outlined in the following tables.

Program Measures

DIABETES - Ages 18 years and older
Process Measure Performance Level: Minimum %
Level 1
Level 2
Level 3

Microalbumin (annual)

75%
80%
90%

Dilated Eye exam (annual by an optometrist or ophthalmologist)

60%
65%
70%
Foot exam (annual)
75%
80%
90%
Outcome Measures
Proportion w/HgA1c less than 8
70%
75%
80%
Proportion w/LDL less than 100
65%
70%
75%

Proportion w/BP less than 140 systolic and less than 80 diastolic
Blood pressure checked each visit

60%
70%
75%

 

HYPERTENSION - Ages 18 years and older
Outcome Measures  

Proportion w/BP less than 140 systolic and less than 90 diastolic

Blood pressure checked each visit
75%
80%
85%

 

CHILDHOOD IMMUNIZATIONS – Age 2 years during the calendar year
Process Measure Performance Level: Minimum %
Level 1
Level 2
Level 3

Children turning two in 2011 who receive 4 DTaP, 3 IPV, 1 MMR, 4 HIB, 3 HEP-B, 1 VZV, 4 pneumococcal conjugate vaccines on or before second birthday.

 

Collaboration on Quality

The Collaboration on Quality program is a collaboration between Wellmark and network clinicians designed to:

  • Measure and calculate clinicians’ performance
  • Support clinicians’ efforts to improve the delivery of health care
  • Provide information to support and inform clinicians
  • Share information with the public regarding a clinician’s participation and performance in the program

 

 
 
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Wellmark Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association doing business in Iowa and South Dakota.
 
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