CommercialAdministrativeLow impact
Quality and HEDIS® Preventive care measures
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice +1 more·Physician
Effective date
Oct 1, 2024
We identified it
Jun 19, 2026
Summary
BCBSRI has outlined key HEDIS preventive care quality measures for their PCP Quality Incentive Program (PQIP), emphasizing that specific screenings like mammograms, colorectal cancer screening, osteoporosis management, and chlamydia screening are covered at no cost to members. This appears to be educational guidance rather than a policy change requiring immediate billing modifications.
Action Required
Review HEDIS quality measures with clinical staff to ensure proper documentation and coding for breast cancer screening (women 50-74), colorectal cancer screening (adults 50-75), osteoporosis management (women 67-85 with fractures), and chlamydia screening (women 16-24). Contact QualityHEDIS@bcbsri.org for questions about the PQIP Program and potential partnership opportunities.