Excellus BlueCross BlueShield Awards Hospitals $25.7 Million for Quality Improvements

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 BlueCross BlueShield’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 BlueCross BlueShield vice president Health Care Improvement.

Hospitals in the Central New York region that participated in this program in 2018 shared $5.6 million in quality improvement incentive payments. Among the participants were Guthrie Cortland Medical Center, Crouse Hospital, Oswego Hospital, St. Joseph’s Health Hospital and Upstate University Health System (two sites).

“In 2018, Excellus BlueCross BlueShield’s Hospital Performance Incentive Program evaluated participating hospitals on 59 unique performance measures,” said LouAnne Giangreco, M.D., Excellus BlueCross BlueShield vice president and chief medical officer for Health Care Improvement. “We credit our hospital partners for their continuous commitment to quality improvement, and for achieving 77 percent of all quality improvement targets.”

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

“We fully appreciate the partnership we’ve developed with providers for the last several years in the spirit of optimizing patient care and influencing overall outcomes. It is through these types of collaborations that we can mutually seek to improve the quality of care across upstate New York,” Whitcher said.