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Home / News & IndustryManaged Care Insight and Analysis
Updated: June 17, 2008
Anthem Blue Cross And Blue Shield’s Improves Safety In Colorado Hospitals

Now in its fifth year, Anthem Blue Cross and Blue Shield in Colorado has hard evidence that its Promoting Healthcare Quality (PHQ) program is working to imrprove the quality and safety of care for patients in hospitals.

Anthem said specifically the improvements were:

  • Of the 19 hospitals participating in this voluntary program, the overall average score increased from 81 to 92 percent.
  • Five of the hospitals increased their total scores by more than 20 percent and five of the hospitals scored 100 percent in the most recent measurement year.
  • One hospital reduced its inpatient mortality rate for heart attack patients from 6.9 percent to 2.4 percent.
  • One hospital improved its pneumococcal vaccination rate from 35 percent to 96 percent for patients with community-acquired pneumonia. Another improved from 55 percent to 93 percent.
  • Overall, ninety-two percent of patients hospitalized with pneumonia received smoking cessation advice – a significant increase from the 53 percent who received this advice during the first year of the program.

Anthem’s PHQ program came about as the result of the 2000 publication of the Institute of Medicine’s (IOM) ground-breaking report, "To Err is Human," which cited as many as 98,000 deaths annually from medical errors and called for a national effort to make healthcare safer.

Anthem was the first health benefits company in the state to introduce this kind of program and has since been recognized as a leader in expanding reimbursement for clinical excellence and improved medical outcomes, rather than limiting it only to delivery of medical services.

PHQ offers hospitals incentives, including financial, for achieving measurable improvements in the areas of patient safety and health outcomes, including such measures as pneumococcal vaccination rate, provision of aspirin and beta blockers for patients suffering a heart attack, computerized physician order entry systems and ICU staffing.

Success is measured by assigning values for compliance with recommended patient safety standards, implementation of systems and processes to meet these standards and improvements in clinical outcomes.

"Good relationships with participating hospitals are at the core of PHQ’s success," said Mike Ramseier, vice president, healthcare management, Anthem Blue Cross and Blue Shield. "Working collaboratively, we have been able to achieve improvement in several areas. This means better, safer care for every patient who receives medical care at these institutions. That’s something we all can be proud of."

"Anthem and PHQ participating hospitals both win as a result of being a part of the program," said Donna Kusuda, vice president quality and patient safety, HCA- HealthONE. "While healthcare providers strive to do the right thing for their patients, putting new systems and processes in place that can enable providers to deliver safer, higher quality services can be challenging. PHQ helps accelerate the timeline for achieving key patient quality and safety goals."

Address: Anthem Blue Cross Blue Shield in Colorado, 700 Broadway, 7th Fl., Denver, CO 80273; (303) 831-2000, www.anthem.com.


  This article was taken from:
Pay-For-Performance Reporter

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