Excellus BCBS Awards Hospitals $21.4 Million For Quality Improvements
February 29, 2012
ROCHESTER – Fifty-three upstate New York hospitals last year earned more than $21 million in quality improvement incentive payments from Excellus BlueCross BlueShield as part of the health insurer’s Hospital Performance Incentive Program (HPIP). In the past three years, quality performance incentives from Excellus BCBS have exceeded $61 million.
“Collaborating with our hospital partners to link payments to improvements in health outcomes and patient safety has resulted in our members getting the best quality of care and the most value for their health care premiums,” said Carrie Frank, vice president of quality and health informatics at Excellus BCBS.
Launched in 2004, the HPIP program evaluates participating hospitals on over 300 performance measures. Target outcomes are jointly agreed upon by each hospital and the health insurer using benchmarks established by the CMS, the Leapfrog Group, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), the Institute for Healthcare Improvement (IHI), and others.
“At Strong Memorial, we’re pleased to partner with Excellus BCBS in the Hospital Performance Incentive Program, working jointly to enhance care quality, safety, and efficiency all at the same time,” said Robert Panzer, M.D., chief quality officer at Strong Memorial Hospital. “This commitment to continual improvement is precisely what our patients and our community deserve.”
The HPIP program targets four areas for improvement:
- Clinical Outcomes – Focused on improvements in heart attack care, heart failure, pneumonia, and surgical care
- Patient Safety – Focused on reductions in hospital-acquired infections, improved medication reconciliation processes, and National Quality Forum Safe Practices
- Patient Perception of Care and Patient Satisfaction – Focused on a hospital’s use of a national survey tool
- Efficiency – Focused on generics utilization, length of stay, and readmissions
“The hospitals participating in our performance incentive program have seen higher scores on their CMS Quality Measures than hospitals whose payments are not at-risk,” said Frank.
CMS is the Centers for Medicare and Medicaid Services and is the federal agency which administers Medicare, Medicaid, and the Children’s Health Insurance Program.
Relevance in upstate New York
In 2007 Excellus BCBS issued a Fact Sheet on hospital acquired infections that showed an estimated 19,500 upstate New Yorkers acquired an infection during a hospital stay in 2004 and nearly a thousand deaths were likely to have occurred as a result. The Fact Sheet, titled Hospital-acquired infections in upstate New York, is available at excellusbcbs.com/factsheets.
About Excellus BlueCross BlueShield
Excellus BlueCross BlueShield, a nonprofit independent licensee of the BlueCross BlueShield Association, is part of a family of companies that finances and delivers vital health care services to 1.8 million people across upstate New York. Excellus BlueCross BlueShield provides access to high-quality, affordable health coverage, including valuable health-related resources that our members use every day, such as cost-saving prescription drug discounts and wellness tracking tools in our Step Up program. To learn more, visit excellusbcbs.com.
The Blue Cross and Blue Shield Association is a national federation of 37 independent, community-based and locally-operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for nearly 105 million members – one-in-three Americans. For more information on the Blue Cross and Blue Shield Association and its member companies, please visit bcbs.com. We encourage you to connect with us on Facebook, check out our videos on YouTube, follow us on Twitter and check out The BCBS Blog, for up-to-date information about BCBSA.