Centura Health Awarded Cash for Quality Care ; Anthem Recognizes Provider
Posted on: Tuesday, 23 August 2005, 03:01 CDT
Centura Health, Colorado's largest health care provider, is the first in the state to get money back from health insurance carrier Anthem Blue Cross Blue Shield under a new payfor-performance incentive program.
Nine of Centura's 12 hospitals in the state will receive a total of nearly $200,000. Thursday, Penrose-St. Francis Health Services accepted a check for $34,030.
Centura manages Catholic and Adventist hospitals in Colorado. Catholic Health Initiatives owns Penrose.
"This is certainly a trend in the industry, as more insurers, including Medicare, are talking about compensation for improved quality," said Dr. P. Terrence O'Rourke, senior vice president and chief medical officer for Centura Health.
Anthem is the first insurance provider to reward hospitals that meet quality standards in treating patients who have had heart attacks, congestive heart failure, pneumonia, hip fractures and coronary bypass surgery. Patient safety issues and overall patient satisfaction also were examined.
"This is a big step for the industry because interaction between health care systems and insurers is usually adversarial and centered around the buck. This shows we both have a common aim -- the patients," said Dr. David Ehrenberger, chief medical officer for Avista-Adventist Hospital in Louisville.
The amount of reimbursement for each Centura hospital is based on how well it scored, as well as patient volume and hospital size, said Mike Ramseier, regional vice president of health care management for Anthem.
"The real goal is not about the money but about doing the right thing in measuring and improving health outcomes and patient satisfaction," he said. "This isn't just for Anthem members; when a hospital agrees to do this, it impacts all patients."
The money hospitals receive is earmarked for further developing approaches to patient quality.
Eighteen other hospitals in Colorado have voluntarily joined Anthem's three-year, quality-measurement pilot program and are in the process of being evaluated, Ramseier said.
Anthem has about 700,000 members in Colorado.
CONTACT THE WRITER: 636-0235 or debbie.kelley@gazette.com
Source: Gazette, The; Colorado Springs, Colo.
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