QOPI® Health Plan Program Information
Introduction
Practices that participate in ASCO’s Quality Oncology Practice Initiative (QOPI) demonstrate commitment to self-assessment and quality improvement. Increasingly, health plans are willing to recognize physicians’ quality improvement efforts, including special designation in physician directories or financial incentives for participating.
In an effort to recognize QOPI participation and reduce redundancy of data collection and measurement, ASCO is pleased to continue the Health Plan Program in collaboration with health plans nationwide.
Through this voluntary, optional program, QOPI participants can request that ASCO send verification of QOPI participation to applicable health plans that participate in the program.
Participating Health Plans
Participating health benefit companies and associations include:
- Advocate Physician Partners
- Aetna
- Anthem Blue Cross and Blue Shield (CO, CT, KY, IN, ME, MO, NH, NV, OH, VA, WI)
- Blue Cross Blue Shield Association**
- Blue Cross of California; BC Life & Health Insurance Company (California)
- Blue Cross and Blue Shield of Georgia, Inc; Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. (Georgia)
- Blue Cross Blue Shield of Michigan
- Empire BlueCross BlueShield (New York)
- Health Alliance Plan
- HMO Colorado and HMO Nevada
- Humana
- UNICARE Life and Health Insurance Company
- UnitedHealthcare
** Blue Cross and Blue Shield Association and its 39 independent Member Plans [http://www.bcbs.com/coverage/find/plan/], through an agreement with ASCO, may recognize providers for their QOPI participation by displaying the QOPI designation seal in the BlueCard National Doctor and Hospital Finder website and on provider locator websites managed by individual Member Plans”. Member Plans having an independent agreement with ASCO may also be listed separately from BCBSA and may receive participation information separately.
How To Participate
Following each round of data collection, practices that successfully completed the round are eligible to participate in the QOPI Health Plan Program. If the practice contracts with any of the listed health plans, they can choose to opt-in to the program, allowing ASCO to verify to the relevant plan(s) that the practice and/or participating sites within the practice successfully completed QOPI. ‘Successful completion’ means the practice office site(s) participated in QOPI for the most recent data collection round and met a minimum chart sample size. It does not include any performance thresholds or the transfer of any practice performance or patient data.
To continue participation in the program, practices must renew their opt-in after successful data collection. Eligible QOPI practices will be notified via email when the opt-in form is available within the QOPI web-based application after the close of the collection round.
Information Sent To Health Plans
The practice information transferred to health plans will be limited to the following:
1. Practice: name, address, phone, taxpayer ID# or NPI.
2. Participating offices/sites: name, address, phone, taxpayer ID# or NPI, modules completed, total number of charts submitted, practicing oncologists/hematologists at each site.
3. Oncologist/Hematologist: name, NPI or UPIN
The opt-in form includes fields for practice personnel to enter all of the information listed above. Practice personnel should obtain appropriate permissions prior to opting in to the QOPI Health Plan Program.
The primary focus of QOPI and the QOPI Health Plan Program remains practice-level or office-level data collection. Physician-level data collection is not required to participate in the QOPI Health Plan Program; however, names of oncologists/hematologists in the practice will be collected on the opt-in form. Some health plans may put a ‘quality seal’ next to the physicians’ names in their provider directories, or otherwise recognize oncologists in participating practices.
The QOPI Health Plan Program will include the transfer of information about QOPI participation only. ASCO will not send any information regarding your practice’s performance data gathered through QOPI.
How To Encourage Health Plans To Join
We welcome additional health plans to the QOPI Health Plan Program. If there are plans you want to see involved, please:
* Provide relevant information on the designated section of the opt-in form, or
* Ask plan representatives to contact us at qopi@asco.org, or
* Send an email to qopi@asco.org with the relevant information (plan name and contact information)
What You Can Expect
The QOPI Health Plan Program is a relatively new program and ASCO cannot dictate how plans recognize participation. We hope and expect that participating plans will offer recognition that is meaningful to QOPI practices. ASCO leadership will continually assess ways to expand QOPI and the QOPI Health Plan Program to best meet our members’ needs.
Questions Or Comments?
As always, please contact qopi@asco.org with any questions or comments.