Despite vigorous objections from ACCMA and CMA, Blue Shield of California will use the flawed quality measurement system known as the California Physician Performance Initiative (CPPI) to publicly identify "Blue Ribbon" physicians within its roster of contracted physicians.  While physicians are supportive of quality measurement and improvement, CPPI is an insurer-driven ratings program that is based only on financial claims data instead of actual clinical outcomes.  Based on the experience of physicians who participated in the CPPI, and after careful review by CMA’s Quality Technical Advisory Committee (QTAC), CMA has concluded that publication of the CPPI will mislead patients in choosing or retaining their physicians, irreparably harm physicians' personal and professional reputation, and is unlikely to address payor concerns about costs.  To protest Blue Shield's irresponsible actions, CMA has formally withdrawn from the CPPI process and has demanded that Blue Shield and the Pacific Business Group on Health (which sponsors the CPPI process) remove any reference to CMA participation or support.  Blue Shield intends to designate "blue ribbons" next to the names of contracting physicians who are "top performers," with a disclaimer stating that the absence of a blue ribbon does not imply that a physician is not a top performer.

The ACCMA and CMA intend to take action to protect the reputations of members who will be unfairly characterized by the CPPI measurement process, and CMA is currently exploring legal challenges to Blue Shield's actions.  In addition, CMA continues working to identify and/or create quality measurement and improvement programs that will result in meaningful information for both physicians and patients that will actually improve quality.  ACCMA members and staff continue to play prominent leadership roles in California's quality debate.