Hospital Quality Program
Categories: Change Incentives to Promote Better Care
Anthem Blue Cross and Blue Shield crafted a hospital quality program to help reduce variation in practice patterns and outcomes among network hospitals. The program has evolved to include an incentive payment for quality, electronic data submission and enhanced sharing of best practices. Now called the Midwest Hospital Quality Improvement Program, it includes 357 hospitals in Ohio, Kentucky, Indiana and Missouri. As part of the program:
- An annual Request for Information (RFI) is sent to each network hospital. The RFI consists of 10 core measures, developed in collaboration with participating hospitals, accrediting bodies and quality organizations. Once the RFI is completed, data are entered into a confidential database, aggregated and analyzed.
- Hospitals receive a report card with their overall score, as well as comparisons to their peer hospitals, matched by size for ease of comparison. The Midwest Hospital Quality Improvement Program changes its measures in response to national and regional trends to incorporate more contemporary approaches for measuring or improving clinical quality.
- Starting in 2003, incentives were paid to high-performing hospitals, while lower-performing hospitals were approached about remediation. However, the goal of this program is not to punish lower-performing hospitals but to work with hospitals in a collaborative fashion to improve care quality.
- Further collaboration is sparked by the annual Hospital Quality Program meetings. Beginning in 2003, hospitals were asked to submit an abstract of a “successful practice,” which is judged by an impartial panel of Quality Improvement Directors from other regions. Winning practices are presented at the Hospital Quality Improvement meetings, allowing for an exchange of ideas among competing hospitals.
