Clinical Resources

The Blue Cross and Blue Shield of Illinois Quality Improvement Program is based on a view that the process for delivery of medical care and services can be continuously improved. The purpose of the QI program is to provide the necessary focus and structure to identify, monitor and evaluate clinical and service improvement opportunities.

CMO Perspective

This page features blog-style entries from Dr. Derek J. Robinson, M.D., MBA, FACEP, CHCQM, Vice President and Chief Medical Officer, BCBSIL. Learn more

Behavioral Health Program

BCBSIL manages behavioral health services for all commercial, non-HMO members who have behavioral health benefits through our group or retail products. Similar behavioral health programs are implemented across product lines but may differ by product. Learn more

Clinical Practice Guidelines

Clinical Practice Guidelines and Preventive Care Guidelines are adopted by BCBSIL and are the foundation for selected Condition Management Programs. These guidelines are based on established evidence-based standards of care, publicized by specialty societies and national clinical organizations. Learn more

Health Equity and Social Determinants of Health (SDoH)

Health equity presents the ideal that everyone deserves a fair shot at living their healthiest possible life. But some populations may be at a disadvantage due to social determinants of health – social, economic or physical conditions they experience at home, school, work and elsewhere in their neighborhoods and communities. Learn more


BCBSIL reports audited Healthcare Effectiveness Data and Information Set results. HEDIS is a nationally standardized set of measures related to important areas of care and service. Developed by the National Committee for Quality Assurance (NCQA), it is one of the most widely used set of health care performance measures in the United States. Learn more

Preventive Care Guidelines

BCBSIL publishes and disseminates evidence-derived Preventive Care Guidelines based upon the recommendations of recognized sources such as professional medical associations, specialty societies, professional consensus panels, national task forces, and governmental entities. Learn more

Quality Improvement

The BCBSIL Quality Improvement Program is based on the view that the process for delivery of medical care and services can be continuously improved. Learn more