Mid Dakota Clinic of Bismarck has opted out of a major initiative by Blue Cross Blue Shield of North Dakota that involves sharing patient records with an outside consultant and cites patient privacy concerns as the reason. The program, MediQHome, is a "medical home" partnership between the health insurer and teams of medical providers aimed at better managing patients, especially those with chronic diseases, such as diabetes or asthma, to improve outcomes and reduce costs. The initiative, which involves more than seven of every 10 primary care clinicians representing 75% of the North Dakota Blues' members, requires providers to share patient information with an outside health quality consultant, MDdatacor, a firm located in suburban Atlanta. Jeff Neuberger, the chief executive officer of Mid Dakota Clinic, said that all patients should be contacted in advance to get their permission before their medical information is sent to a third party for review. The clinic's legal counsel, he said, concluded that failure to get individual patients' express approval would violate a federal law protecting patient privacy, the Health Information Portability and Accountability Act.