Excellus BlueCross BlueShield Awards Hospitals $22.9 Million for Quality Improvements

leva doyle
Monday, February 27, 2017

Excellus BlueCross BlueShield Awards Hospitals $22.9 Million for Quality Improvements

SYRACUSE, N.Y. -- Forty upstate New York hospitals and health centers, including eight in Central New York, shared $22.9 million in quality improvement incentives paid by Excellus BlueCross BlueShield. Quality incentives reflect 2016 performance against specific quality measures. Since the program launched in 2005, the health insurer has paid $232 million in hospital quality incentives.

"We're pleased that our collaboration with providers has resulted in higher quality scores and increased value for our members," said Tony Vitagliano, Excellus BlueCross BlueShield vice president for health system performance.

The eight hospitals in the Central New York region that participated in this program in 2016 shared $5.7 million in quality improvement incentive payments. The hospitals included Auburn Community Hospital, Auburn; Cortland Regional Medical Center, Cortland; Crouse Hospital, Syracuse; Oswego Hospital, Oswego; Samaritan Medical Center, Watertown; St. Joseph's Hospital Health Center, Syracuse; and Upstate University Health System (two sites in Syracuse).

Hospitals and health systems were evaluated on 244 measures, including target outcomes jointly agreed upon by each participant and the health insurer using benchmarks established by the Centers for Medicare & Medicaid Services, The Joint Commission, the Institute for Healthcare Improvement, and others. Hospitals that earned incentive payments achieved at least 85 percent of their quality targets.

Areas targeted for 2016 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.