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Excellus awards hospitals $19 million for quality improvements

UTICA, N.Y. - Fifty-two upstate New York hospitals last year earned more than $19 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 two years quality performance incentives from Excellus BCBS have exceeded $40 million.

"By tying our payments to these hospitals to improvements in health outcomes and patient safety, we're helping assure that our members and all others get the best quality care and the most value for their health care dollars," said Carrie Frank, vice president of quality and health informatics at Excellus BCBS.

Ten hospitals in the Utica/Rome/North Country Region participated in this program in 2010, including Adirondack Medical Center, Alice Hyde Medical Center, AO Fox Memorial Hospital, Bassett Medical Center, Champlain Valley Physicians Hospital Medical Center, Community Memorial Hospital, Faxton-St. Luke's Healthcare, Oneida Healthcare Center, Rome Memorial Hospital and St. Elizabeth Medical Center.

"The Excellus BlueCross BlueShield program has provided additional focus to our Quality Improvement Program," said Dr. Albert D'Accurzio, vice president for medical affairs at St. Elizabeth Medical Center. "It also provides the financial resources necessary to implement programs that improve the quality of care. We are pleased that we were able to achieve all of our quality targets in 2010."

"Quality is at the core of our vision of providing exceptional care," said Dr. Istikram M. Qaderi, associate vice president of quality resources at Champlain Valley Physicians Hospital Medical Center. "We aligned our quality measures with our strategic plan to make sure that all moved in the same direction and understood the importance of each individual's contribution to success."

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. Four areas are targeted 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

"Having a financial incentive to improve quality has resulted in participating hospitals consistently scoring higher on 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 US 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 archived under the heading "Hospitals" in the News & Information section of www.excellusbcbs.com.

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