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March 2015

Blues award providers with distinction

For the second year, BCN AdvantageSM and Blue Cross Blue Shield of Michigan’s Medicare Plus BlueSM have recognized health care providers for their outstanding contributions to our star ratings from the Centers for Medicare and Medicaid Services. Click here to view our list of the Provider Distinction Award honorees.

Plaques were awarded in the following categories:

  • BCN Advantage only
  • Medicare Plus Blue only
  • Joint BCN Advantage and Medicare Plus

Providers also received gifts for their office staff that perform administrative work. These gifts included travel coffee mugs, lunch bags and containers and a combination stylus, pen and flashlight.

Our partnership with providers is critical to the continued achievement of the star ratings we receive from the Centers for Medicare and Medicaid Services. CMS uses a five-star rating system to measure the quality, performance and member outcomes of each Medicare Advantage plan and line of business.

To be eligible for a 2014 Provider Distinction Award:

  • The provider had to achieve a score of 80 percent or above on star measures — such as diabetes care, colorectal cancer screening and others — with Blue Cross Blue Shield of Michigan members only and BCN Advantage members only, or jointly with patients from both plans. If providers achieve greater than 80 percent in any of those categories, then they pass the first eligibility test for the award.
  • Providers must have a minimum of five services that count toward the
    star rating (for example, a diabetes test, colorectal screening). The star measure rating is determined by the number of services completed divided by the number of eligible services.
  • Providers must be currently credentialed and contracted with Blue Cross Blue Shield of Michigan and BCN Advantage and in good standing.
  • Providers may not have low quality ratings based on the quality score reports generated by Blue Cross and BCN Advantage. Providers with low quality ratings will be eligible for future awards once they have completed our quality score rating program.
No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2014 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.