California Physician Performance Initiative (CPPI)

Steering Committee Charter

Approved February 2007

Physician Performance Initiative Steering Committee Purpose

The Steering Committee will provide expertise, guidance and decisions regarding all aspects of the strategic direction and implementation of the CCHRI BQI Pilot and expanded California Physician Performance Initiative, subject, where necessary, to ratification by the CCHRI Executive Committee.

Physician Performance Initiative Project Goals

In conformance with the original goals established by national AQA Alliance for its pilots, the goals of the CCHRI Initiative are to:

1. Test the application of the AQA starter set measures and other clinical quality measures that can be derived from administrative data sources, patient experience, and cost-efficiency measures at the individual provider level.
2. Define and produce provider and consumer reports that combine quality, efficiency, and patient experience results in a meaningful and actionable manner, and provide guidelines on proper interpretation and limits of reports.
3. Promote the use of valid performance information for performance improvement, provider recognition and reward, and value purchasing (by both employers and consumers), and otherwise support the Federal Government’s Transparency initiative as appropriate.

The BQI Pilot represents the first stage in meeting these goals. Sponsored by CMS and AHRQ, the pilot has the more limited goal of testing 12 AQA quality measures on combined Medicare and commercial data and developing actionable reports for physicians and consumers. The BQI Pilot will provide the foundation for expansion to include a broader set of payer data and quality and cost-efficiency measures.

Steering Committee Role and Responsibilities

Decision making process:

• Each member will serve for a 2 year period
• Each member has one vote
• To conduct business requiring decisions 51% of the steering committee must be present, if 51% of the members are not present, voting for all members will occur via email.
• A vote on Initiative business requires approval by 2/3rds of the members present. Irresolvable issues will be deferred to the CCHRI Executive Committee for resolution.
• PBGH reserves the right to veto a decision if it conflicts with contractual obligations to entities such as CMS/Delmarva and the data aggregation vendor or causes undue financial risk to PBGH.
• Decisions that impact the overall efforts of CCHRI will require ratification of the CCHRI Executive Committee.

The Steering Committee is charged with the following:

• Approve new members
• Elect special-purpose work group members and approve work group charters
  • Data Work Group
  • Physician Engagement Work Group
• Make decisions regarding proposed measure sets and methodology
• Approve selection of vendors. Subgroups will be formed to evaluate vendors and make vendor selection recommendations to the Steering Committee as appropriate.
• Make decisions on the development, content, and distribution of clinical quality, patient experience, and cost-efficiency measurement reports.
• Provide input on issues identified by the project staff
• Provide input on issues identified by the national BQI pilot work group.
• Work with the project manager to ensure that the BQI Pilot project meets the project scope, timeline, and deliverables agreed upon with CMS/Delmarva.
• Identify and approve funding sources and budgets for the expanded initiative.
• The Steering Committee will provide regular reports regarding progress and decisions to the CCHRI Executive Committee.

Steering Committee Commitment

Each Steering Committee member agrees to the following:

• Will attend each of the Steering Committee meetings to be convened as needed. It is anticipated that many of these will be via conference call.
• If unable to attend a meeting the member will designate an alternative representative from their organization to participate on their behalf.
• Will review meeting materials prior to meetings, if the documents are provided to the group at least 24 hours before the meeting

Steering Committee Representation

Voting members of the Steering Committee will be composed of:

• One representative from each of the three PPO participating health plans
• One representative from an HMO plan
• One representative each from PBGH and CalPERS
• One representative from an individual employer
• One consumer representative
• One representative from Lumetra
• One representative from CAPG
• One physician/CMA representative
• One solo practice physician

Additional membership to be added as the Initiative expands beyond the core BQI Pilot include:

• Two representatives from participating physician groups
• One representative from Kaiser

» Return to CPPI index

Blue Shield of California launched its physician quality recognition program June 1, 2010. Network physician listings include physician quality designations for a set of 8 CPPI quality measures. A set of physicians, who have sufficient patient samples to be reliably scored, have been designated as higher quality performing physicians for select preventive screening and chronic care measures. Blue Shield members can view this new information in the plan's online physician directory. See the Blue Shield announcement here.

Physicians in the Blue Shield network who would like to request a duplicate of the Physician Performance Report that you received last summer may request a copy here.

The CPPI 2010 physician quality measurement and reporting is getting underway. This summer, patient care quality will be evaluated using an expanded number of quality measures. Results will be mailed to physicians in August. At that time, physicians are encouraged to go online, review their patient-level results and make any corrections due to missing data or patient circumstances. Details and dates will be announced here in June.

CCHRI Senior Manager
Julie France, PBGH
jfrance@pbgh.org