Provider Programs – Quality Management Programs
Anthem Quality Insights
Program Description
The Anthem Quality Insights Program (AQI) is a suite of innovative quality recognition and
health improvement programs that offers financial rewards to Anthem network providers and
hospitals that meet or exceed industry standards of quality health care.
The rewards are based on industry standard measures of quality developed by the National
Committee for Quality Assurance (NCQA), the Joint Commission on Accreditation of
Healthcare Organizations (JCAHO), the National Quality Forum (NQF, the Institute for
Healthcare Improvement or IHI), The Leapfrog Group, and other acclaimed organizations.
Quality Incentive Program for Primary Care Providers
Developed in 2005 to reward Anthem network providers for quality primary care services, the
AQI Quality Incentive Program for Primary Care Providers uses industry standard measures of
quality like HEDIS.
The Primary Care Quality Incentive Program is open to participating providers who specialize in
Internal Medicine, Family Practice, General Practice, or Pediatrics. To be eligible, the provider
must be designated as a Primary Care Provider (PCP) as their primary specialty and provide
services to members with Anthem commercial plans and products (HMO, POS, PPO, and
Traditional/Indemnity) in New Hampshire.
Quality Incentive Program for Cardiology and Obstetrics/Gynecology
The AQI Quality Incentive Program for Cardiology and Obstetrics/Gynecology rewards Anthem
network providers for specialty care services. The rewards are based on industry standard
measures of quality like HEDIS®.
This Quality Incentive Program is open to participating providers whose primary specialty is
Cardiology or Obstetrics/Gynecology; and physicians who are providing services to members
with Anthem commercial plans and products in New Hampshire.
Anthem Blue Cross and Blue Shield – Provider Manual
March 2011