Excellus awards Upstate hospitals millions in quality-improvement funding

Monday, March 6, 2017

Source: Central New York Business Journal

Excellus BlueCross BlueShield has awarded 40 Upstate hospitals and health centers a total of nearly $23 million in quality-improvement incentives.

The 40 hospitals include eight in Central New York and nine in the Utica/Rome/North Country region, the health insurer recently announced in separate news releases.

Quality incentives reflect 2016 performance “against specific quality measures,” Excellus said in the news release.

Since the program launched in 2005, the health insurer says it has paid $232 million in hospital-quality incentives.

“We’re pleased that our collaboration with providers has resulted in higher quality scores and increased value for our members,” Tony Vitagliano, Excellus’s VP for health-system performance, said in the nonprofit’s release.



The eight hospitals in the Central New York region that participated in this program in 2016 shared $5.7 million in quality improvement incentive payments.

The hospitals included Upstate University Hospital’s downtown Syracuse and Community campuses; Crouse Hospital and St. Joseph’s Hospital Health Center, both in Syracuse; Auburn Community Hospital; Cortland Regional Medical Center; Oswego Hospital; and Samaritan Medical Center in Watertown.

Nine hospitals in the Utica/Rome/North Country region also participated in the program in 2016, sharing nearly $905,000 in quality improvement incentive payments.

Participating hospitals included Faxton St. Luke’s Healthcare of Utica and St. Elizabeth Medical Center of Utica, both of which are part of the Mohawk Valley Health System.

The participating hospitals also include Rome Memorial Hospital, Oneida Healthcare, Community Memorial Hospital in Hamilton, Aurelia Osborn Fox Memorial Hospital in Oneonta, Mary Imogene Bassett Hospital in Cooperstown, Adirondack Medical Center in Saranac Lake and Lake Placid, and Champlain Valley Physicians Hospital Medical Center in Plattsburgh.


Evaluation measures

Hospitals and health systems were evaluated on 244 measures, including target outcomes jointly agreed upon by each participant and Excellus, using benchmarks that the Centers for Medicare & Medicaid Services, The Joint Commission, the Institute for Healthcare Improvement, and “others” established, the health insurer said.

Hospitals that earned incentive payments achieved at least 85 percent of their quality targets.             

Excellus also noted a few areas that were “targeted” for improvement in 2016.

They included what Excellus labeled as “clinical processes of care,” or improvements in heart-attack care, heart failure, pneumonia, and surgical care, along with other measures that “may be unique to each participating hospital.”

Another area of focus, patient safety, centered on reductions in hospital-acquired infections, falls, pressure ulcers, readmissions, and other “adverse events or errors” that affect patient care.

A third area of focus — patient satisfaction — involved the “Hospital Consumer Assessment of Healthcare Providers and Systems” survey, which is the “first national, standardized, publicly reported survey of patients’ perspectives of hospital care,” according to Excellus.

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