New York hospitals land $22M in quality incentives

By Bernie Monegain
10:25 AM

Forty-eight upstate New York hospitals earned more than $22 million in quality improvement incentive payments from Excellus BlueCross BlueShield as part of the health insurer's Hospital Performance Incentive Program.

Launched in 2004, the program uses nationally recognized standards and guidelines to address specific areas for improvement, including clinical outcomes, patient safety, patient satisfaction and efficiency.

For example:

  • Upstate University Hospital in Syracuse increased by 26 percent its adult smoking cessation advice/counseling rate, increasing from 74 percent to 100 percent the number of adults who received this advice and counseling.
  • United Health Services in Binghamton improved its overall rate of initial antibiotic received within six hours of hospital arrival by 10 percent, increasing from 84 percent to 94 percent.
  • Unity Hospital in Rochester had an increase of 25 percent for colorectal surgery patients with immediate postoperative normothermia, improving its rate from 59 percent to 84 percent.
  • Champlain Valley Physicians Hospital Medical Center in Plattsburgh improved its rate for surgery patients who received appropriate venous thromboembolism prophylaxis within 24 hours prior to surgery to 24 hours after surgery by 33 percent, an increase in rate from 59 percent to 92 percent.

"Hospitals in the program should be applauded for putting some of our payments to them at risk by adding accountability for quality to their business relationship with our health plan," said Carrie Frank, vice president of quality and health informatics at Excellus BlueCross BlueShield. "By tying our payments to them 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 healthcare dollars."

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.

"Working with Excellus BlueCross BlueShield complements our robust quality improvement program at Upstate University Hospital," said James Legault, the Syracuse hospital's director of clinical practice analysis and infection control. "The ability to combine our goals with Excellus BCBS works well for both organizations."

"The HPIP program has helped us focus our efforts and seek opportunities to improve patient care," said Joseph Salipante, MD, vice president for medical affairs, chief medical officer at Unity Health System in Rochester.

Excellus BlueCross BlueShield's Hospital Performance Incentive Program evaluates participating hospitals on 280 different performance measures.

Each hospital and Excellus agree upon target outcomes using benchmarks established by the Centers for Medicare and Medicaid, the Leapfrog Group, the Joint Commission and the Institute for Healthcare Improvement (IHI).

"We've seen a great deal of support for this program from our hospital partners," said Frank, noting that it helped many of the hospitals accelerate quality improvement initiatives that had been planned but not yet implemented.