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Home » Ontario County » Clifton Springs » Excellus BCBS awards $28M to Upstate NY hospitals including Clifton Springs, Newark-Wayne, and Thompson

Excellus BCBS awards $28M to Upstate NY hospitals including Clifton Springs, Newark-Wayne, and Thompson

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  • Staff Report 

Excellus BlueCross BlueShield, a nonprofit health insurer, has distributed $28 million in quality improvement payments to thirty-one upstate New York hospitals and health centers. This initiative is part of the organization’s Hospital Performance Incentive Program, which has contributed over $400 million to quality improvements since 2005.

Excellus says the program reflects the company’s commitment to ensuring equitable access to high-quality healthcare in the community, but has recently been criticized for not updating reimbursement rates to WellNow Urgent Care, which sits as one of the region’s remaining healthcare access points beyond hospitals.

In the region, nine hospitals shared $16.6 million of the total incentive payments in 2022. The beneficiaries 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. These hospitals participated in the program by undertaking various projects aimed at enhancing health care quality and responsiveness to the evolving health care environment.

The program’s evaluation criteria for 2022 included several key areas: Clinical Processes of Care, focusing on post-hospitalization follow-ups and specific conditions such as diabetes and COPD; Patient Safety, with goals to reduce hospital-acquired infections and readmissions; and Patient Satisfaction, assessed via the Hospital Consumer Assessment of Healthcare Providers and Systems survey. In addition to meeting these criteria, hospitals agreed upon additional nationally endorsed measures and targets in collaboration with Excellus BCBS, using benchmarks from the Centers for Medicare & Medicaid Services and the Institute for Healthcare Improvement. The program’s success highlights a concerted effort to elevate healthcare standards across upstate New York.