Clear Choice Quality Awards Program ©

In 2008 the Quality Awards Program will remain unchanged from the 2007 service year. All requirements and scoring mechanisms will continue to be based on the information below. In order to qualify for the program, COIPA providers will have to register AND activate their accounts by 05/31/2008. The Clear Choice Quality Awards Program will continue to be applied only to the Medicare Advantage line of business. In the future, we are hoping to expand the Program to include commercial plans. The program has three main measures emphasizing the importance of evidence-based decision making; appropriateness guidelines for imaging and improvement in clinical quality measures. Specifically, each of the following three components will count toward 1/3 of the scorecard for the potential award. Registering for and use of UpToDate.com as a reference tool. UpToDate.com is an online reference tool that continuously monitors over 330 medical journals and other sources providing detailed evidence based updates on over 10,000 clinical topics. Use of the American College of Radiology – Appropriateness Criteria/Radiology utilization. A “clinical quality” score based on HEDIS measures such as LDL determinations etc. Consistent with AMA Guidelines, the program will: Implement evidenced-based measures to ensure quality care. Foster the physician-patient relationship. Utilize accurate and fair reporting. Provide fair and equitable incentives. We continue to evolve and expand the program as we gain more experience with our provider community and we look forward to sharing with you a new Quality Awards Program in 2009. Sincerely, Joseph Johnson, MD