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Excellus BCBS awards hospitals $30 million for quality improvements

More than 30 hospitals in Upstate New York are getting millions in quality improvement payments from Excellus BlueCross BlueShield last year as part of the nonprofit health insurer’s Hospital Performance Incentive Program. Since 2005, Excellus BCBS has paid out more than $371.2 million in quality improvement incentives.

“It’s part of our mission to ensure that all in our communities have equitable access to high quality health care,” said Melissa Gardner, executive vice president, chief population health engagement officer at Excellus BCBS. “The foundation for achieving that is a collaborative relationship with our local hospital and physician partners.”

DiSanto Propane (Billboard)

Nine hospitals in the Rochester Region participated in this program in 2021, sharing $14.6 million in quality improvement incentive payments. Participating hospitals included Clifton Springs Hospital & Clinic, Highland Hospital, Newark-Wayne Community Hospital, Noyes Memorial Hospital, Rochester General Hospital, Strong Memorial Hospital, Thompson Health, United Memorial Medical Center and Unity Hospital.

“In 2021, Excellus BCBS’s Hospital Performance Incentive Program evaluated participating hospitals on projects that are in alignment with and responsive to the ever-changing health care environment,” said Stephen Cohen, M.D., senior vice president and corporate medical director at Excellus BCBS. “Although COVID is still a dominant issue for the hospitals, the best evidence that this collaboration is a success is that our partners are able to maintain focus on continuous quality improvement.”

Areas targeted for improvement in 2021 included:

  • Clinical Processes of Care – Focused on improvements in follow up after hospitalization, diabetes, chronic obstructive pulmonary disease (COPD), surgical care, and other measures 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

In addition to meeting required clinical and patient safety measures in 2021, 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.