Clinical Quality Initiative Program

Overview

The Clinical Quality Initiative, or CLQI, aims to improve the quality health care delivered by PGIP participating physicians by rewarding physician organizations, or POs, that support population-wide adoption and implementation of evidence-based medical guidelines into their daily practice. The CLQI consist of selected Health Effectiveness Data and Information Set (HEDIS) and Centers for Medicare & Medicaid services star measures to compare performance of PGIP physician organizations.

To achieve success in CLQI, POs and Providers need to do the following:

• Identify opportunities for improvement in measures by conduction of data analysis and continuous quality improvement processes.
• Induce and deploy best practices among their physician communities that results in safe and effective care.
• Support innovation and constructive change in processes for the delivery of care.
• Promote better outcomes and coordination of care across provider settings.
• Develop and implement strategies for population health management.

Data Deliveries

• We receive and review data distributed by BCBSM by identifying practice units that represent opportunity for improvement.
• We utilize prospective data reports, dashboards, and quality scorecards.
• We develop and implement intervention plans such as trend reports to improve HEDIS performance.