Tenn. Blues Plan Gives PCPs High Marks for Quality

For the fifth year in a row, BlueCross BlueShield of Tennessee (BCBST) recently celebrated the achievements of hundreds of high-performing primary care physicians in its PPO network. The provider engagement effort is part of an enterprise-wide initiative that has helped the insurer maintain a 4-star rating from CMS for its Medicare Advantage PPO plan while observing continued population-level improvement on key quality metrics, including patient experience measures that will soon receive an increased weighting in the CMS star ratings program.

In an Aug. 17 press release, the insurer named 43 providers and practices across the state who earned a 4.5 out of 5 star rating in BCBST’s Medicare Advantage 2019 Quality+ Partnerships Program. One of them, Charles A. Ross, M.D., of Kingsport, earned a 5-star rating. Many more physicians and practices were recognized on the insurer’s website for achieving a rating of 4 stars or higher. BCBST serves approximately 157,000 MA enrollees overall, including 138,000 lives in its PPO plans.

© 2024 MMIT
Lauren Flynn Kelly

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.

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