Priority Health "apple" doctor quality ratings
Each year, Priority Health measures the quality of the health care that primary care doctors and other primary health care providers (PCPs) give to our members. These quality ratings are shown in "apples." Four apples is the highest score for each kind of care measured.
Choose your doctor based on quality ratings
It just makes sense to choose a doctor who scores high in quality. To see any PCP's "apple" ratings, use the online Find a Doctor directory to search for primary care physicians. You can sort the results of your search to show the PCPs with the most apples at the top.
Why your doctor might not be rated
We only award apple quality ratings when a doctor has enough Priority Health patients for our rating to be fair and accurate. For some measures, PCPs must have at least 10 Priority Health patients for us to rate the quality of their care. For other measures, it takes 30 or more Priority Health patients.
How scoring works
- We look for the percentage of a PCP's Priority Health patients who received the services targeted for measurement this year.
- Some scores are based not on the individual doctor's patients, but on the patients of all doctors who practice together.
- We use medical claims data, audits of medical records, Michigan Department of Community Health data, and other sources to tell us that percentage.
- Physicians earn a score of 4 apples if they meet a target. PCPs who score in the highest 1/3 of performance below the target rate earn three apples on a measure; the middle 1/3 score 2 apples; and the lowest 1/3 earn one apple. When PCPs don't have enough Priority Health patients for us to score them fairly, their information shows an "N/A" instead of apples.
Why don't specialists have "apple" ratings?
The care and services offered by each specialty is different, so ratings of specialist quality will be different - and at the moment, we can't create and track many different sets of measures for specialists.