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Physician "Apple" Quality Ratings

Physician Quality
FAQ
Why don't specialists get "apple" ratings for quality?
The care and services offered by each specialty is different. This means we may have to create many different sets of measures for specialists. We began with PCPs because these are the health care providers our members rely on most often.

Each year, Priority Health measures the quality of the health care that primary care physicians and other primary care providers (PCPs) give to our members. These quality ratings are shown in "apples." Four apples is the highest score for each kind of care measured.

Choose Your Doctor Based on Quality Ratings

It just makes sense to choose a doctor who scores high in quality. To see any PCP's "apple" ratings, use the Find a Doctor tool to search for Primary Care Physicians. You can sort the results of your search to show the PCPs with the most apples at the top.

How Scoring Works

  • We look for the percentage of a PCP's Priority Health patients who received the services targeted for measurement this year.
  • Some scores are based not on the individual doctor's patients, but on the patients of all doctors who practice together.
  • We use medical claims data, audits of medical records, Michigan Department of Community Health data, and other sources to tell us that percentage.
  • Physicians earn a score of 4 apples if they meet a target. PCPs who score in the highest 1/3 of performance below the target rate earn three apples on a measure; the middle 1/3 score 2 apples; and the lowest 1/3 earn one apple. When PCPs don't have enough Priority Health patients for us to score them fairly, their information shows an "N/A" instead of apples.

Last modified 08/03/06