Clinician Star Ratings

For over ten years the Health Care Incentive Improvement Institute (HCI3) has been creating programs, called Bridges to Excellence, that allow clinicians to voluntarily submit clinical data to be assessed for a Quality of Care Recognition. Since that time, the number of clinicians that have participated has risen from 10 to over 20,000.

But there is vast room to expand. More clinicians need to participate and we all need to be part of the movement towards improvement.   If you want to receive and promote high quality medical care you should select a doctor or hospital of the highest quality. You should also speak up and ask questions. 

Doctor and Nurse Ratings

These ratings indicate the quality of healthcare that the selected provider demonstrates. The more stars you see, the higher quality care you can expect. The highest level a clinician can earn is five stars.
1 Star –

  • The doctor or nurse has demonstrated that he/she is a licensed medical professional

OR

  • The doctor’s practice has demonstrated that they have a computerized system in their practice.

2 Stars –

  • The doctor or nurse has demonstrated “good” care in a chronic care program, such as diabetes, cardiac care or asthma

OR

  • The doctor’s practice has demonstrated they have a computerized system that can perform basic functions.

3 Stars –

  • The doctor or nurse has demonstrated “very good” care in a chronic care program, such as diabetes, cardiac care or asthma

OR

  • The doctor’s practice has demonstrated they have a computerized system that can perform advanced functions.

4 Stars –

  • The doctor or nurse has demonstrated “exceptional” care in a chronic care program, such as diabetes, cardiac care or asthma

5 Stars –

  • The doctor or nurse has demonstrated “exceptional” care in a chronic care program, such as diabetes, cardiac care or asthma AND they have a computerized system that can perform advanced functions.

Doctors and nurses voluntarily submit clinical information to national and regional organizations that provide independent, objective evaluations of doctor and nurse performance using nationally accepted measures. The organizations do not make a profit on taking in or publishing the doctor and nurse information.

Asthma Care Recognition

To earn Recognition, clinicians must meet benchmarks on measures such as:

  • Lung function test and monitoring
  • Appropriate medication therapy
  • Smoking termination
  • Annual influenza vaccination
  • Patient self-management plan

Cardiac Care Recognition

To earn Recognition, clinicians must meet benchmarks on measures such as:

  • Blood pressure and LDL levels
  • Complete lipoid (fatty substance) profile
  • Use of aspirin or other antithrombotic drugs
  • Smoking termination 

Congestive Heart Failure (CHF) Care Recognition

To earn Recognition, clinicians must meet benchmarks on measures such as:

  • Beta Blocker therapy
  • LV function assessment
  • Appropriate ACE-I/ARB therapy
  • Assessment of patient weight and activity level
  • Patient education

Chronic Obstructive Pulmonary Disease (COPD) Care Recognition

To earn Recognition, clinicians must meet benchmarks on measures such as:

  • Spirometry evaluation and monitoring
  • Inhaled bronchodilator therapy
  • Smoking termination
  • Assessment of oxygen saturation and long-term oxygen therapy
  • Annual influenza vaccination

Coronary Artery Disease (CAD) Care Recognition

To earn Recognition, clinicians must meet benchmarks on measures such as:

  • Blood pressure and lipid management
  • Evaluation of activity level and anginal symptoms
  • Smoking termination
  • Aspirin/blood clot prevention therapy
  • Beta blocker treatment after a heart attack

Depression Care Recognition

To earn Recognition, clinicians must meet benchmarks on measures such as:

  • Patient Health Questionnaire assessment tool use
  • Relative improvement of symptoms
  • Remission rate

Diabetes Care Recognition

To earn Recognition, clinicians must meet benchmarks on measures such as:

  • Blood pressure
  • LDL levels
  • HgBA1c levels
  • Eye and foot and leg exams
  • Kidney assessment

Hypertension Care Recognition

To earn Recognition, clinicians must meet benchmarks around such measures as:

  • Blood pressure and lipid management
  • Aspirin use
  • Diabetes screening
  • Smoking termination
  • Urine protein test
  • Counseling for diet and physical activity

Inflammatory Bowel Disease (IBD) Care Recognition

To earn Recognition, clinicians must meet benchmarks around such measures as:

  • IBD Type, location, disease activity and external appearance assessed
  • Corticosteroid-Sparing Therapy prescribed
  • Bone loss assessment
  • Testing for latent tuberculosis before anti-tumor necrosis factor (TNF) therapy
  • Hepatitis B assessment
  • Influenza immunization
  • Pneumococcal immunization
  • Tobacco Screen and termination counseling

Physician Office System

To obtain Recognition, practices must demonstrate that they have implemented systematic office processes to reduce errors and increase quality. The program includes three levels of recognition:

  • Level I elements assess the use of evidence-based standards of care; maintenance of patient registries to identify and follow up with at-risk patients; and provision of educational resources to patients.
  • Level II elements assess whether practices use electronic systems to maintain patient records; provide decision support; enter orders for prescriptions and lab tests; and provide patient reminders.
  • Level III elements assess whether a practice's electronic systems interconnect and are "interoperable" with other systems whether they use nationally accepted medical code sets or they can automatically send, receive and integrate data such as lab results and medical histories from other organizations' systems.

Spine Care Recognition

To earn Recognition, clinicians must meet benchmarks around such measures as:

  • Recommendations for appropriate physical activity
  • Avoidance of unnecessary imaging
  • Appropriate use of epidural injections and surgical procedures
  • Patient education
  • Shared decision-making with the patient about surgery and alternatives to surgery.

BTE Medical Home

This program requires a practice to demonstrate that it is collecting and using information to improve the management of patient care, and that it is using electronic systems to promote patient safety. Clinicians/practices can achieve recognition in the BTE Physician Office Systems Recognition program in two ways.

  • Option 1 - Achieve a NCQA Patient Centered Medical Home recognition of level II or III.

-OR-

  • Option 2 - Have a meaningful use certified electronic medical record system

          -AND -

  • Positive patient outcomes are identified through the achievement of Level II or III in any two BTE Care Recognition programs, which demonstrate that clinicians are measuring and reporting clinical performance data resulting in improved delivery of care.

For more information on the Bridges to Excellence Program, visit http://www.hci3.org/what_is_bte