Quick Links:

Specialist Performance Initiative

Highmark’s Specialist Performance Initiative (SPI) provides cost and quality insights to eligible specialists and True Performance primary care physicians (PCPs). SPI includes ranking information on over 11,000 specialists in 14 clinical specialty groupings and 52 clinical condition categories giving Highmark’s network brand new insights into performance to help them provide and guide our members to the highest value care possible. SPI includes the following specialties: cardiologists, dermatologists, endocrinologists, general surgeons, gastroenterologists, gynecologists, nephrologists, neurologists, ophthalmologists, orthopedic specialists, psychologists, pulmonologists, rheumatologists, and urologists.

All eligible specialists will be ranked based on observed/expected (O/E) performance scores within various clinical condition categories. Specialist profiles enable comparisons of the relative cost of care among providers who practice in the same region and specialty. The specialist profiles will be based on four Highmark service areas – Western, PA; the combined Central and Northeastern, PA regions; West Virginia and Delaware and include health system physicians and independent doctors, including Highmark partners.

SPI is an informational only cost performance profile tool to help physician groups monitor care cost. It is not a reimbursement program at this time.

If you have questions regarding SPI, submit your inquiry to SpecialistPerformance@highmark.com.

Last updated on 11/18/2022 3:42:35 PM

 

To Top

Report Site Issues

Contact Us

Provider Directory

Site Map

Legal Information

Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Highmark Western and Northeastern New York Inc., serves eight counties in Western New York under the trade name Highmark Blue Cross Blue Shield of Western New York and serves 13 counties in Northeastern New York under the trade name Highmark Blue Shield of Northeastern New York. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration.