Premera Premier Provider program expands to help members find high-quality, affordable care nationwide
Premera Blue Cross and Premera Blue Cross HMO has enhanced its Premera Premier Provider (3P) program, expanding it from a regional solution to a national provider designation program that helps members identify healthcare providers who deliver high-quality, cost-effective care.
3P now leverages the Blue Cross Blue Shield Association’s Axis Provider Insights (API) dataset, allowing Premera to evaluate providers across national Blue networks and bring greater consistency and scale to provider performance measurement. This data has enabled the 3P program to go from a primarily local offering to a national footprint with over 200,000 providers holding the Premera Premier Provider designation.
3P includes providers across 20 specialties representing roughly 60% of medical spending, including:
- Primary care
- Cardiology
- Oncology
- Endocrinology
- Pediatrics
- Orthopedics
- Pediatrics
- Psychiatry
View a complete list of specialties.
Providers are assessed using three performance domains:
- Appropriateness – evidence-based decision making and avoidance of unnecessary or low-value care
- Quality – adherence to clinical guidelines and avoidance of complications
- Cost – efficiency of care delivery and total cost of care relative to peers
Providers who achieve top performance levels may receive:
- An Affordability designation based on cost performance
- A Quality designation based on quality or appropriateness performance
- Both designations when they excel across multiple areas
These designations are identified with an icon next to the provider on the Premera Find Care tool, making it easy for members to compare providers and identify those recognized for delivering high-value care.
By bringing provider performance information directly into the Find Care experience, 3P helps members choose care with greater confidence and supports employers’ efforts to improve quality outcomes while managing health care costs.
3P goes beyond simple identification. Premera customer service and case management teams can use the information when helping members find a provider or care guidance, and Kinwell providers can access 3P for referral support.
Why this matters to your clients
The expanded 3P program supports affordability by helping members identify providers who consistently deliver strong outcomes while managing costs effectively. Employer groups can take comfort in knowing that their employees can access high-quality affordable care no matter where they reside.
3P designation doesn’t affect provider reimbursement, contract rates, or claims payment, and members remain free to choose any in-network provider. 3P offers additional transparency and guidance for members seeking care with their Premera plan.
Learn more about the Premera Premier Provider program.