Blue Cross Blue Shield of Texas - List of Evidence Based Measures Indicators

List of Evidence Based Measures Indicators - 2007

BCBSTX uses Evidence Based Measures (EBM) to evaluate aspects of physician performance based on claims and enrollment data. These indicators were developed based on nationally recognized evidence based guidelines. Compliance to the measures below were used for BlueCompare 2007 and for the BlueChoice Solutions network evaluation for calendar year 2008.

#	Category	Description
1	Preventive Screening	Cervical Cancer Screening
2	Preventive Screening	Chlamydia Screening for Women
3	Preventive Screening	Colorectal Cancer Screening
4	Preventive Screening	Mammography Screening
5	Diabetes	Diabetic Retinal Exam
6	Diabetes	Glycosylated Hemoglobin (HbA1c) for Diabetics
7	Diabetes	Lipid Panel for Diabetics
8	Diabetes	Monitoring for Diabetic Nephropathy
9	Childhood Immunizations	Childhood Immunization: Measles, Mumps and Rubella (MMR)
10	Childhood Immunizations	Childhood Immunization: Varicella-Zoster Virus (VZV)
11	Antibiotic Use	Appropriate Testing for Children with Pharyngitis
12	Antibiotic Use	Inappropriate Use of Antibiotics for Viral URI
13	Medication Adherence	Adherence to Antihypertensive Medication
14	Medication Adherence	Adherence to Inhaled Corticosteroids for Persistent Asthmatics
15	Medication Adherence	Adherence to Lipid-Lowering Medication
16	Medication Adherence	Adherence to Glaucoma Medications
17	Mental Health/Other	Follow-up with Children Initiating ADHD Medication Therapy
18	Mental Health/Other	Treatment of Major Depression: Acute Phase Management
19	Medication Monitoring	Appropriate Medication Use in the Elderly1
20	Medication Monitoring	Appropriate Medication Use in the Elderly2
21	Medication Monitoring	Hepatic Enzyme Monitoring for Statin Use
22	Medication Monitoring	Liver Function Tests (LFT) and Complete Blood Counts (CBC) for Patients Initiated on Carbamazepine or Valproic Acid
23	Respiratory Illness	Use of Long-Term Control Drugs in Asthma
24	Respiratory Illness	Use of Spirometry Testing in the Assessment and Diagnosis of COPD
25	Ophthalmology	Annual Visual Field Tests for Glaucoma Patients
26	Ophthalmology	Postoperative Complications After Cataract Surgery
27	Heart Disease	Beta Blocker Persistence Following a Heart Attack
28	Heart Disease	Treatment of Coronary Artery Disease: Monitoring Lipid Levels
29	Cancer/Other	Radiation Therapy Following Breast Conserving Surgery
30	Cancer/Other	Follow-Up After Initial Diagnosis and Treatment of Colorectal Cancer
31	Musculoskeletal	Conservative Use of Imaging for Lower Back Pain
32	Musculoskeletal	Osteoporosis Screening Following Fractures
33	Musculoskeletal	Osteoporosis Screening for Patients on Systemic Corticosteroids
34	Musculoskeletal	X-Ray Prior to MRI or CAT Scan in the Evaluation of Lower Back Pain
35	Avoidance of Complications	Risk-Adjusted Complication Likelihood for Surgeries
36	Avoidance of Complications	Risk-Adjusted Complication Post Total Knee Replacement