Pay for Quality Program - CareFirst Quality Rewards (CQR)

CareFirst Quality Rewards | CareFirst Quality Rewards - Surgeons

CareFirst Quality Rewards (CQR), a pay-for-quality program, is designed in collaboration with our customers, national health care industry organizations and network physicians, to reward physicians for effective and affordable health care delivery.

Currently, voluntary participation is limited to the specialties listed below. Other physician specialties will be invited in coming years.

Physicians must be active in the following networks to participate. Physicians must also have sufficient claims volume to support the measurement of affordability.

• CareFirst BlueChoice
• GHMSI (Select Preferred Provider (SPP) and Participating)

Note:

• We will accept physician-submitted data on NCQA recognition, Joint Commission accreditation, and Maintenance of Certification Part IV on a continuous basis.
• We will update a physician's most recent CQR Assessment Report on a continuous basis for the above new achievements only.
• If a doctor earns a new reimbursement rate, it will be effective 90 days after we are notified of the achievement.

For more information about the CQR program click below:

• CQR Overview (98KB, 1 pg.)
• 2008 Program Measurement Table (634KB, 4 pgs.)
• 2009 Program Measurement Table (649KB, 4 pgs.)
• External Organization Brochure (810KB, 4 pgs.)
• Frequently Asked Questions (564KB, 4 pgs.)
• Getting Started with CQR (49KB, 1 pg.)

The following documents are offered to physicians who want more information about how CareFirst administers:

• The CQR Effectiveness Measure, HEDIS-Physician Mesurement
  (National Committee for Quality Assurance) (88KB, 16 pgs.)
• The Affordability Dimension Impacting the CQR Achievement Fee Schedule
  (120KB, 18 pgs.)