Massena Memorial Hospital was one of 52 upstate New York hospitals that earned a total of $19 million in quality improvement incentive payments from Excellus BlueCross BlueShield as part of the health insurer’s Hospital Performance Incentive Program.
“By tying our payments to these hospitals to improvements in health outcomes and patient safety, we’re helping assure that our members and all others get the best quality care and the most value for their health care dollars,” said Carrie Frank, vice president of quality and health informatics at Excellus BlueCross BlueShield.
Massena Memorial Hospital participated in this program in 2010.
The program evaluates participating hospitals on more than 300 performance measures. Target outcomes are jointly agreed upon by each hospital and the health insurer using benchmarks established by the Centers for Medicare & Medicaid Services, the Leapfrog Group, the Joint Commission on the Accreditation of Healthcare Organizations, the Institute for Healthcare Improvement and others.
Four areas are targeted for improvement:
• Clinical Outcomes, focused on improvements in heart attack care, heart failure, pneumonia and surgical care.
• Patient Safety, focused on reductions in hospital-acquired infections, improved medication reconciliation processes and National Quality Forum Safe Practices.
• Patient Perception of Care and Patient Satisfaction, focused on a hospital’s use of a national survey tool.
• Efficiency, focused on generics utilization, length of stay and readmissions.
“Having a financial incentive to improve quality has resulted in participating hospitals consistently scoring higher on CMS Quality Measures than hospitals whose payments are not at-risk,” said Frank. CMS is the federal agency that administers Medicare, Medicaid and the Children’s Health Insurance Program.