Thirty-six Upstate New York hospitals and health centers last year earned $25.7 million in quality improvement payments from Excellus BlueCross BlueShield as part of the nonprofit health insurer’s performance incentive program.
Since 2005, Excellus BCBS’s program has paid out more than $282 million in quality improvement incentives.
“When a health insurer collaborates with health care providers, as we are doing with this hospital quality program, health outcomes improve, and incentives are fully aligned for the communities we jointly serve,” said Carrie Whitcher, Excellus BCBS vice president health care improvement.
Eight hospitals in the Utica-Rome-North Country region participated in this program in 2018, sharing $1 million in quality improvement incentive payments. Participating hospitals included Adirondack Medical Center, Bassett Medical Center, Champlain Valley Physicians Hospital, Faxton St. Luke’s Healthcare, Oneida Healthcare, Rome Memorial Hospital, Samaritan Medical Center and St. Elizabeth Medical Center.
In addition to achieving required clinical and patient safety measures in 2018, other nationally endorsed measures and target outcomes were jointly agreed upon by each hospital and the health insurer using benchmarks established by the Centers for Medicare & Medicaid Services, the Institute for Healthcare Improvement, and others.
Areas targeted for 2018 improvement included:
— Clinical processes of care: Focused on improvements in diabetes, chronic obstructive pulmonary disease, pneumonia, and surgical care, and other measures that may be unique to each participating hospital
— Patient safety: Centered on reductions in hospital-acquired infections, readmissions, and other adverse events or errors that affect patient care
— Patient satisfaction: Used the hospital consumer assessment of healthcare providers and systems survey, which is a national, standardized, publicly reported survey of patients’ perspectives of hospital care.