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Excellus BCBS Awards Hospitals $29.3 Million for Quality Improvements

Published on: February 20, 2020

Utica, N.Y. – Thirty-six upstate New York hospitals and health centers last year earned $29.3 million in quality improvement payments from Excellus BlueCross BlueShield as part of the nonprofit health insurer’s Hospital Performance Incentive Program. Since 2005, Excellus BCBS’s program has paid out more than $311 million in quality improvement incentives.

“When we launched this initiative several years ago, we knew that its success would hinge on a high level of cooperation and collaboration among our health plan and our hospital partners,” said Carrie Whitcher, vice president for care improvement at Excellus BCBS.

Eight hospitals in the Utica/Rome/North Country region participated in this program in 2019, sharing $1 million in quality improvement incentive payments. Participating hospitals included Adirondack Medical Center-Saranac Lake, Bassett Medical Center, Champlain Valley Physicians Hospital, Faxton St. Luke’s Healthcare, Oneida Health Hospital, Rome Memorial Hospital, Samaritan Medical Center and St. Elizabeth Medical Center.

“In 2019, Excellus BCBS’s Hospital Performance Incentive Program evaluated participating hospitals on 38 unique performance measures,” said Dr. Stephen Cohen, senior vice president and corporate medical director at Excellus BCBS. “The best evidence that this collaboration is a success is that our hospital partners met 96 percent of all quality improvement targets.”

Areas targeted for 2019 improvement 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 2019, 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.

“Our health plan’s Hospital Performance Incentive Program is a great example of a rising tide lifting all boats,” said Whitcher. “The quality of health care for all patients, regardless of their health insurer, is on the rise across upstate New York because of the commitment to continuous improvement by Excellus BCBS and our hospital partners.”

Excellus BlueCross BlueShield, an independent licensee of the Blue Cross Blue Shield Association, is a nonprofit health plan with 1.5 million upstate New York members. The company’s mission is to help people live healthier and more secure lives through access to high-quality, affordable health care. Its products and services include cost-saving prescription drug discounts, wellness tracking tools and access to telemedicine. With more than 3,500 employees, the company is committed to attracting and retaining a diverse workforce to foster innovation and better serve its members. It also encourages employees to engage in their communities by providing paid volunteer time off as one of many benefits. To learn more, visit ExcellusBCBS.com.