A total of 54 upstate New York hospitals and health centers shared $26 million from Excellus BlueCross BlueShield for quality improvements, the insurer announced Wednesday.
The payments are part of the insurer’s Health Performance Incentive Program, which since 2004 has paid more than $145 million to participating hospitals in its 39-county region.
All five Monroe County acute-care hospitals earned payments, as well as Clifton Springs Hospital & Clinic and F.F. Thompson Hospital in Ontario County, Newark-Wayne Community Hospital in Wayne County, and Nicholas H. Noyes Memorial Hospital in Dansville, Livingston County.
Each year, hospitals negotiate with Excellus over targets in specific areas of improvement and put a percentage of their inpatient payments at risk. If the hospital fails to meet its goals, it loses that money. If it hits the targets, it receives the payments.
Want to publish your own articles on DistilINFO Publications?
Send us an email, we will get in touch with you.
Carrie Whitcher, director of provider performance improvement and analytics for Excellus, said that each hospital has its own set of goals, and usually risks 1 percent to 3 percent of the payments it expects from Excellus. The 54 hospitals as a group achieved 87 percent of all target quality levels. Exact amount of the payments varied by hospital, based on their contract with the insurer.
The areas for improvement are outcomes in heart attack care, heart failure and pneumonia care; patient safety such as fewer hospital acquired infections; patient satisfaction; and measures of efficiency such as use of generics and readmissions. Whitcher said targets are agreed upon by the hospital and the insurer, and are based on nationally accepted benchmarks.