Excellus BCBS Awards Hospitals $24.5 Million for Quality Improvements

ROCHESTER, NY (02/25/2014)(readMedia)-- Forty-seven upstate New York hospitals and health centers last year earned $24.5 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 ten years, quality performance incentives from Excellus BCBS have exceeded $169 million.

"With all the changes in health care brought about by the Affordable Care Act, we applaud our hospital partners for continuing to focus on improving the quality of care and patient safety," said Carrie Frank, vice president of quality and health informatics at Excellus BCBS.

"We are pleased to be able to collaborate with Excellus BlueCross BlueShield in improving the safety and efficiency of the care we deliver," said Richard Magnussen, M.D., Associate Medical Director, UR Medicine's Highland Hospital. "Our patients are the direct beneficiaries of this continuous quality improvement initiative."

Launched in 2004, the HPIP program evaluates participating hospitals on over 250 performance measures. In 2013, hospitals achieved 89 percent of all target quality levels. In addition to required clinical and patient safety measures, other nationally-endorsed measures and target outcomes are jointly agreed upon by each hospital and the health insurer using benchmarks established by the Centers for Medicare & Medicaid Services (CMS), The Joint Commission (TJC), the Institute for Healthcare Improvement (IHI), and others.

Areas targeted for improvement include:

• Clinical Processes of Care – Focused on improvements in heart attack care, heart failure, pneumonia, and surgical care
• 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 – Using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, which is the first national, standardized, publicly-reported survey of patients' perspectives of hospital care

"Excellus BCBS has continued to reward improvements in quality through our contracts with hospitals," said Frank. "These improvements also have the effect of lowering the costs of care, which is critical to hospitals in this environment."

Relevance 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, according to an Excellus BCBS fact sheet, Hospital Acquired Infections in Upstate New York.

If upstate New York hospitals could lower the number of hospital-acquired infections by even 20 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 state hospitals an estimated $68 million to $137 million annually.

# # #

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 about 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.