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Employer News | February 2016
Employer News | February 2016

Excellus BCBS Awards Hospitals $22.4 Million for Quality Improvements

Forty-one upstate New York hospitals and health centers last year earned $22.4 million in quality improvement payments from Excellus BlueCross BlueShield as part of its performance incentive program. Since 2005, Excellus BCBS program has paid out more than $210 million.

"To provide the best value for our customers, collaboration with our provider partners is more important than ever as we identify new best practices to improve health outcomes and use health care resources more effectively," said Tony Vitagliano, Excellus BlueCross BlueShield vice president health system performance.

In 2015, Excellus BlueCross BlueShield's Hospital Performance Incentive Program evaluated participating hospitals on more than 241 performance measures. Hospitals that received quality improvement incentive payments achieved 90 percent of all quality improvement targets.

In addition to achieving required clinical and patient safety measures in 2015, 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 Joint Commission, the Institute for Healthcare Improvement, and others.                                 

Areas targeted for 2015 improvement included:

  • Clinical Processes of Care – Focused on improvements in heart attack care, heart failure, pneumonia, and surgical care, and other measures that may be unique to each participating hospital
  • Patient Safety – Centered on reductions in hospital-acquired infections, falls, pressure ulcers, 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 the first national, standardized, publicly-reported survey of patients’ perspectives of hospital care

Relevance in upstate New York 

From the Excellus BCBS Spring 2013 Fact Sheet on Hospital Acquired Infections in upstate New York.

In 2010, New York state reported about 108,000 hospital-acquired infections, including 24,000 in upstate New York. Those hospital-acquired infections led to an estimated 5,000 New York state deaths, 1,100 of which were in upstate New York.

If upstate New York hospitals could lower the number of hospital-acquired infections by even 20 percent or 40 percent, there would be an estimated 5,000 to 10,000 fewer infections and 200 to 400 fewer associated deaths, the Excellus BCBS report concludes. That would also save upstate New York hospitals an estimated $68 million to $137 million annually.

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