Blue Cross And Blue Shield’s Improves Safety In Colorado
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
- 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
- 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
"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.