Two doctors discussing a patient's chart

Understanding how we measure

Our methodology for evaluating effectiveness (may also be described as clinical quality) and efficiency (also described as cost-efficiency) of care is consistent with national standards and incorporates physician feedback.

For detailed information about how we evaluate effectiveness and efficiency, please see the manual for Physician Effectiveness and Efficiency .

Find your measures

To see the effectiveness and efficiency measures that apply to you, please select a specialty below and review the applicable measures.

Select Specialty

Working with us

  • Delegated resources
  • Effectiveness and efficiency
  • HIPAA
  • Important policy updates
  • Medicare Advantage materials
  • Medicare hospice VBID
  • Pharmacy news
  • Physician initiated patient transfers
  • Provider compliance
  • Publications
  • Quality resources

Access Reports and Information

To learn how physicians can access the Clinical Quality and Cost-Efficiency Reports in Availity, review the Availity Quick Guide.

For a complete list of effectiveness measures, see the measures guide.

To provide feedback about the program, please complete the Physician Survey .

Prior Manuals and Guides

Prior Year Physician Effectiveness and Efficiency Manual

Prior Year Measures Guide