Quality Ribbon Transparency (QRT)

The performance scores for each quality measure are calculated over a rolling 12-month period from the last available report date. These individual scores are available for providers hereopens in a new tab (login required). Typically the data has a 45- to 60-day lag to allow for claim processing. Badges are then awarded based on averages of the measures in each of the following 4 categories:

1. Preventive ribbon badge
2. Diabetes ribbon badge
3. Medication adherence ribbon badge
4. Pediatric ribbon badge 

You can see your public facing ratingsopens in a new tab by searching your name on our online provider directory. These ratings update as available throughout the year (typically quarterly). 

Currently, this program only applies to Family Medicine (FM), Internal Medicine (IM), Pediatrics (Peds), OB/GYN, & Certified Nurse Midwives (CNM). Providers in the applicable specialties must also meet a minimum criterion of 30 unique patients to qualify for each measure. The measures included in calculating the badges depend on the provider’s specialty. The include:

• Preventive Ribbon Measures
• Diabetes Ribbon Measures
• Medication Adherence Ribbon Measures
• Pediatric Ribbon Measures

(For more information, see the associated topics below.)

The ribbon thresholds shown below are used to reflect the breakdown of provider quality performance on each individual measure compared nationally. To earn a badge for a category on Select Health’s provider search a provider must have an average ribbon rating of 3.5 or higher (putting them in the 75th percentile or better nationally) in the measures applicable to that category. If a provider does not have a badge, they either do not have enough patients who are Select Health members to gather data for the measures or it can mean the provider performs below the 75th percentile. Ribbon rating thresholds change once yearly when new benchmarks are available nationally.

If you have data in the QRT program, you may access your provider reportopens in a new tab (login required) to see your current ratings. For help navigating this report, access the QRT Tutorialopens in a new tab.

Proxy Access.

Currently proxy access to QRT reports is not available. However, notifications can be sent by email to pre-identified quality champions when reports are updated. To opt-in to this option or to update your current quality champion information, please send contact information for the staff members that need to be notified of QRT updates to the Quality Improvement Team at qualityimprovement@selecthealth.org.

If you are a participant in the Select Health Quality Provider Program (QPP), this data will look very similar. Note that the work you do in that program will reflect in your rates for this program. You do not need to double your efforts by also using this program’s reports as an actionable list.

For detailed correction information, please review the Quality Ribbon Corrections documentationopens in a new tab. If you need to submit clinical documentation to update or correct your ratings, please contact the Quality Improvement Team at qualityimprovement@selecthealth.org for details on documentation requirements.

All measures included apply to FM & IM specialties

• Blood Pressure Medication Adherence
• Diabetes Medication Adherence
• Cholesterol medication Adherence

All measures included apply to FM & Peds specialties

• Childhood Immunizations Combo 7
• Adolescent Immunizations Combo 2
• Child and Adolescent Well-Care Visits

For more detail on these measures please see the measures definitions pageopens in a new tab on your individual ribbon rating reports (login required).

As members view badges earned, they are encouraged to remember that their compliance can impact a physician’s score. For example, if a physician recommends a specific test or medical service, and the patient chooses not to have the test or service, the physician does not receive “credit” for that recommended care. This can negatively impact provider scores and is intended to encourage patient-provider collaboration in health care.