New provider performance information to be displayed in Find Care

As part of our ongoing commitment to transparency, quality improvement, and value-based care, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is introducing a new enhancement to the Find Care provider directory. This enhancement will display provider performance insights validated through Blue Cross NC Provider Performance Analytics to help members make more informed decisions when selecting care. These insights use claims-based analytics, with quality and clinical appropriateness measures informed by Motive Medical Intelligence methodology and cost measures informed by Blue Health Intelligence methodology.

This feature is informational only. It does not affect contracting, payment, or network participation.

What providers can expect

Beginning in Q3 2026, commercial members using the Find Care tool will begin to see provider performance indicators for certain specialists across eight high-impact specialties:

• Cardiovascular disease
• Endocrinology
• Orthopedics
• Pulmonology
• Neurology
• Obstetrics & gynecology
• Otolaryngology (ENT)
• Gastroenterology

The indicator will appear as a small banner on a provider’s profile, accompanied by brief explanatory language that highlights their alignment with evidence-based quality and appropriateness standards.

Impact on providers

All participating providers within applicable specialties will remain visible within the directory, and no providers will be excluded from the directory based on their quality designation or lack thereof.

This enhancement will not alter network status, reimbursement, or credentialing, nor will it affect member access. The intent is simply to make quality and value information more accessible and understandable for members seeking care.

Quality designation criteria

A provider will receive the quality designation if the applicable performance evaluation meets designation criteria based on the available claims-based methodology, specialty-specific measures, data availability, minimum thresholds, or composite performance results. The evaluation may include factors such as adherence to evidence-based clinical guidelines, quality of care, clinical appropriateness of care, and cost of care, depending on the specialty and available data.

For questions, please email ProviderAnalyticsInquiry@bcbsnc.com.