Swipe Right to Find a Primary Care Physician

Finding a primary care doctor can be a bit like online dating. You have to look at all the information available to find a match that’s best for you. Factors like location, education, interests and friend/family referrals can all play a part in your selection. But it can still feel like a big decision.

Wellmark Blue Cross Blue Shield, a health plan providing coverage to more than two million people in Iowa and South Dakota, gives its members a key piece of information to help make that choice easier. They developed a simple quality score to help their members better understand and evaluate primary care physicians. The numeric score appears in members’ search results when they are in Wellmark’s member portal.

We recently hosted an online chat with Wellmark’s VP of Health Networks & Innovation, Mike Fay, and Director of Network Innovation, Sheryl Terlouw, to learn more about why they provide this information to members and to share insights into the plan’s overall quality strategy. You can listen to the full recording of the session here.

So many metrics, so little time

Our industry provides plenty of quality measures. Lots of them. The problem is that many are academic, industry-insider measures, or just don’t apply to a person selecting a primary care physician for themselves or a family member. They can also be difficult to understand. According to Fay, “people need a simple way to understand quality—something like a Consumer Reports score.”

Wellmark worked with its population health partner, 3M Health Information Systems, to deploy their Value Index Score(SM). As Terlouw explained, “under the hood, the score includes 16 measures and six domains of quality, such as primary and secondary prevention, follow-up care and efficiency. All that rolls up into one easy to understand number that quantifies the quality of care.”

Collaboration and communication are key to success

The plan worked with closely with a number of health care organizations in this effort. Terlouw noted that accountable care organization physicians were actively engaged in understanding the goals and how to improve their own scoring before anything was rolled out to members. Each PCP knows what goes into their scores and are empowered to improve their scores. “People are naturally competitive, and doctors are no different. They were interested in comparing their performance to other physicians in their group and our network,” added Terlouw.

After engaging with physicians, Wellmark worked with HealthSparq to roll the score out as part of the online member health care navigation experience. Now, as members search for doctors, read patient reviews and get cost estimates for care, they can get a single score to help them understand physician quality.

Empowering members and driving engagement

Not only does the quality measure help members as they evaluate providers, Wellmark used quality as a core element of their member engagement marketing efforts. After just a three-month campaign the organization increased portal registrations by more than 13%. Member engagement around looking for health care providers and costs also increased by more than 24%.

Overall, it is clear people need help in making important decisions on their health care. Making it easy for them to understand health care provider quality is a challenge, but it pays off. But, don’t take my word for it. Learn more about how Wellmark’s efforts to improve quality care for their members and how they’ve engaged physicians in that process. A replay of the AHIP webinar is available here!