Excellus awards regional hospitals payments for quality improvements

Six hospitals in Central New York, eight hospitals in the Utica/Rome/North Country region, and four hospitals in the Southern Tier secured quality-improvement funding from Excellus BlueCross BlueShield.

Excellus awarded a total of 31 upstate New York hospitals a combined $30 million in quality improvement payments last year as part of the health insurer’s hospital-performance incentive program

Since 2005, Excellus has paid out more than $371.2 million in quality improvement incentives.

Rochester–based Excellus is Central New York’s largest health insurer.

Six hospitals in Central New York participated in the program in 2021, sharing $6.4 million in payments. They are: Auburn Community Hospital, Crouse Hospital in Syracuse, Guthrie Cortland Medical Center, Oswego Hospital, St. Joseph’s Hospital Health Center in Syracuse, and Upstate University Health System (both the downtown Syracuse campus and the Community campus in the town of Onondaga).

Eight hospitals in the Utica/Rome/North Country region participated, sharing $851,000. The participating hospitals are Adirondack Medical Center-Saranac Lake, Champlain Valley Physicians Hospital, Faxton St. Luke’s Healthcare (FSLH) in Utica, Bassett Medical Center in Cooperstown, Oneida Health Hospital, Rome Memorial Hospital, Samaritan Medical Center in Watertown, and St. Elizabeth Medical Center (SEMC) in Utica. FSLH and SEMC are part of the Mohawk Valley Health System.

In addition, four hospitals in the Southern Tier participated, sharing $7.5 million in payments. They included Arnot Ogden Medical Center in Elmira, Guthrie Corning Hospital, and Our Lady of Lourdes Memorial Hospital and United Health Services in Binghamton.

“In 2021, Excellus BCBS’s Hospital Performance Incentive Program evaluated participating hospitals on projects that are in alignment with and responsive to the ever-changing health care environment,” Dr. Stephen Cohen, senior VP and corporate medical director at Excellus, said. “Although COVID is still a dominant issue for the hospitals, the best evidence that this collaboration is a success is that our partners are able to maintain focus on continuous quality improvement.”

Improvement areas

Areas targeted for improvement in 2021 included clinical processes of care, which focused on improvements in follow up after hospitalization, diabetes, chronic obstructive pulmonary disease (COPD), surgical care, and other measures unique to each participating hospital.

They also included patient safety, which centered on reductions in hospital-acquired infections, readmissions, and other adverse events or errors that affect patient care.

A third area, patient satisfaction, involved the use of the Hospital Consumer Assessment of Healthcare Providers and Systems survey. It’s a national, standardized, publicly reported survey of patients’ perspectives of hospital care

In addition to meeting required clinical and patient-safety measures in 2021, 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, Excellus said.