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Physician Quality Measurement Program

Physician Quality Measurement Program is complimentary to Blue Physician Recognition Program. By assisting members in selecting a provider through the display of clinician performance measurements, supporting data and local comparison scores on the Blue National Doctor & Hospital Finder, PQM gives patients information they need to make informed health care decisions.

 

How Does the Program Work?

PQM incorporates HEDIS® provider measures to provide opportunities to assess current practice and identify areas for improving the delivery of health care. They can also be used to compare the performance of physicians and other clinicians in a geographical area.

 

The data displayed is based on the individual provider score.

 

Wellmark selected the Cancer Screening Category and will initially be providing data for the Breast Cancer Screening Category and the Cervical Cancer Screening Measures. Specifically, the guidelines for these two measures are:

  • Breast Cancer Screening:  Percentage of women 40–69 years of age who had a mammogram to screen for breast cancer.
  • Cervical Cancer Screening:  Percentage of women 21–64 years of age who had one or more Pap tests to screen for cervical cancer.

 

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