July 22, 2026
The updated methodology for our Provider Efficiency, Appropriateness, & QualitySM program is now available. This methodology explains how PEAQ evaluates provider performance.
What’s new this year
PEAQ is updating its efficiency component to use Blue Cross and Blue Shield Association data. Efficiency measurements for all providers will still be based on a model that compares expected costs to actual costs. Primary care providers are evaluated on total fee-for-service costs, and specialists on episode-based costs.
Other updates include specialties measured, types of providers evaluated, methods for provider attribution and patient risk adjustment factors.
For details, refer to the methodology document.
Why we’re making changes
BCBSA data includes claims nationwide and allows us to expand coverage to more providers within measured specialties. PEAQ’s quality and appropriateness components are already measured nationwide. With changes this year, claims are applicable to all components.
What this means for you
The updated methodology applies to future Provider Performance Insight reports. PPI reports show how providers compare to their peers and are the basis for Provider Finder® rankings and other tiering.
Physicians can access PPI reports in Availity® Essentials. Nurse practitioners, physician assistants and registered nurses can email PEAQ Inquiries for reports.
For more information, refer to PEAQ or email PEAQ Inquiries.
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