Data sharing and reporting to physicians
To support PGIP initiatives such as the radiology initiative, BCBSM is committed to providing actionable data and reports to PGIP physicians. Currently, BCBSM can only share the minimum necessary amount of information to allow physician organizations to evaluate individual PGIP provider performance and adherence to the evidence based guidelines. However, POs have expressed concerns that their ability to improve the quality of the care of their patients and bring the radiology use more in line with established benchmarks is hampered by the absence of ordering physician identifiers. POs need to know who the ordering physicians are to develop strategies to ensure appropriate use of imaging services. BCBSM has re-visited this issue and determined that this is a clearly identifiable reason for the disclosure of the identity of the physician from a health care operations perspective. Beginning with the next radiology claim data sets, ordering physicians will be identified.

Future specific requests for data will be evaluated and documented on an individual basis as it could result in groups obtaining specific data if they develop different plans for working with PGIP initiatives.