CMA met with Blue Shield last month to discuss the insurer’s plans to publish the results of the 2009 California Physician Performance Initiative (CPPI). Despite serious concerns with the validity and accuracy of the data that has been collected, Blue Shield continues to move forward with plans to give digital “blue ribbons” to physicians who scored in the top 50th percentile. Although Blue Shield has not backed down from its plans to publish the data, the insurer has agreed to continue the dialogue with CMA to see if there is a middle ground.

CPPI is a quality reporting pilot project operated by the California Cooperative Healthcare Reporting Initiative (CCHRI). Over the past two years, CPPI has used claims data from private PPO patients from Anthem Blue Cross, Blue Shield, and United Healthcare to measure physicians on a set of quality measures. Blue Cross and United have not yet indicated whether they will publish the CPPI results.

CMA is very concerned about the implications of making this data public, given the serious concerns about its accuracy. Even a “partial” publication of the results, as is being planned by Blue Shield, is problematic given the faulty data used to score physicians. It also infers that some physicians are not quality doctors because they did not receive a “blue ribbon.”

CMA continues to work to dissuade Blue Cross and other payors from publishing the 2009 CPPI results, and to persuade CCHRI to fix the flaws in the CPPI data gathering process before moving forward with the project. CMA’s Board of Trustees recently approved forming a Quality Technical Advisory Committee to facilitate CPPI discussions with Blue Shield and others.

Contact: Armand Feliciano, 916/444-5532 or afeliciano@cmanet.org.