2009 Blue StarSM Medical Group/IPA Report with Blue RibbonSM Results
The Blue Star Medical Group/IPA Report recognizes HMO contracting medical groups/Independent Practice Associations (IPAs) that have documented high levels of performance in providing patient care. Annually, Blue Cross and Blue Shield of Illinois (BCBSIL) assesses medical group performance based upon national clinical practice and preventive care guidelines. Groups earn a "blue star" each time they meet the target care goal.
HMO members can use the Blue Star Medical Group/IPA Report – along with the Blue Star Hospital Report — to help them choose health care providers that best meet their needs. To make it even easier for members to use the Report, this information is now linked to the Provider Finder® .
Performance Measures and Results
Groups earn a “blue star” each time they meet or exceed the target care goal in each of the reporting categories. Medical groups/IPAs that did not participate are not eligible for a Blue Star (the number and percentage of groups achieving a blue star are listed below):
The criteria are:
- Asthma Care: At least 65 percent of members with persistent asthma received a written asthma action plan. 86 medical groups (75%) earned a blue star
- Diabetes Care: A high level of performance in providing routine diabetic care was demonstrated by meeting at least four of seven care thresholds. 84 medical groups (73%) earned a blue star
- Mental Health Follow-Up: At least 60 percent of members had a follow-up visit with a behavioral health provider within seven days of hospital discharge for a mental health condition. 98 medical groups (85%) earned a blue star
- Childhood Immunization: At least 65 percent of children received eighteen recommended shots by their second birthday. 88 medical groups (77%) earned a blue star
- Breast Cancer Screening: At least 60 percent of women age 42-69 had a mammogram within two years. 95 medical groups (77%) earned a blue star
- Influenza Vaccination: At least 50 percent of high risk members had a flu shot during the 2007-2008 flu season. 52 medical groups (45%) earned a blue star
- Management of Cardiovascular Conditions: A high level of performance in providing routine care for members with cardiovascular disease was demonstrated by meeting at least two of three care thresholds. 111 medical groups (97%) earned a blue star
- Controlling High Blood Pressure At least 60 percent of members with a diagnosis of hypertension had their blood pressure controlled. 100 medical groups (87%) earned a blue star
- Colorectal Cancer Screening: At least 40 percent of members age 51-80 were screened for colorectal cancer. 85 medical groups (74%) earned a blue star
- Blue Ribbon Report: Medical groups/IPAs that earn a composite satisfaction rate of 85 percent or higher (based on a member survey). 91 medical groups (79%) earned a blue ribbon
All percentages are rounded.
Summary of Results
Of the 115 medical groups/IPAs included in the Blue Star Report:
- 33 groups (29%) received all nine blue stars
- 29 groups (25%) received eight blue stars