Quality-Based Programs

Provider Quality Reports

The Provider Quality Reports use Blue Cross NC claims data to rank performance according to nationally accepted standards and measures. These new monthly reports replace all previous gap care reports and are designed to help point out patient care gap areas. These areas can range from telling when a patient is overdue for a screening to determining when a follow-up visit to the doctor's office is needed. Most importantly, the reports will help you improve patient care and keep your patients healthy.

Blue Distinction Centers and Blue Distinction Centers+

The Blue Distinction ® Centers and the Blue Distinction® Centers+ designations (BDC and BDC+) recognizes medical facilities providing a high level of specialty care within specialty areas. Blue Distinction Centers+ Designation recognizes medical facilities for providing a high level of specialty care at lower cost. Find facilities for a variety of procedures, such as cardiac care and spine surgery.

Tiered Network Product

As the North Carolina health insurance marketplace evolves, so does Blue Cross and Blue Shield of North Carolina (Blue Cross NC). In order to respond to our customer's increasing demand for cost-efficient and high-quality health care, Blue Cross NC is announcing the creation of a new Tiered Network product. Blue Cross NC's Tiered Network product will offer consumers the opportunity to maximize benefits and coverage at preferred PPO facilities and providers that meet the quality and cost criteria set forth in the product design.

Hospital Quality Program

The Hospital Quality Program is focused on improving the quality of hospital care available to our members. The program is designed to evaluate hospital performance using a standard set of nationally-recognized quality measures. It also drives improvements in care by collaborating with the hospital community.