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Employer News | February 26, 2013
Employer News | February 26, 2013

Univera Healthcare Awards Hospitals $26 Million for Quality Improvements

Fifty-four upstate New York hospitals and health centers last year earned $26 million in quality improvement incentive payments from Univera Healthcare and its Rochester-based parent as part of the health insurer’s Hospital Performance Incentive Program. In the past nine years quality performance incentives from Univera Healthcare have exceeded $145 million.

“Our many years of working with our hospital partners to drive improvement in quality of care and patient safety by linking payments to improvements in health outcomes provides a strong foundation for the new models of collaboration anticipated with health care reform." said Carrie Frank, vice president of quality and health informatics at Univera Healthcare. 

Participating in this program in 2012 were nineteen Western New York hospitals and health centers, including Lake Erie Regional Health System of New York (2 sites), Catholic Health System (3 hospitals), Chautauqua Integrated Delivery System, Eastern Niagara Health System (2 hospitals), Erie County Medical Center, Kaleida Health (5 hospitals), Mount St. Mary’s Hospital, Niagara Falls Memorial Medical Center, Roswell Park Cancer Institute, United Memorial Medical Center and Women’s Christian Association (WCA) Hospital.

“Our team at Mount St. Mary’s has worked hard to meet and surpass the goals of the Hospital Performance Incentive Program to achieve positive outcomes in clinical care through our healing without harm initiative (patient safety), through improving our patients’ experience (patient satisfaction) and in reducing readmissions,” said Judith A. Maness, president and CEO of Mount St. Mary’s Hospital and Health Center in Lewiston, New York.

“Our Health Ministry continues its close collaboration with Univera Healthcare and in doing so we are providing our patients with the highest quality of care in an effective and efficient manner,” added Maness. “The Hospital Performance Incentive Program continues to be a success for our facility as well as others through Univera’s commitment to continuous quality improvement.”

Launched in 2004, the Hospital Performance Incentive Program evaluates participating hospitals on more than 300 performance measures. In 2012, hospitals achieved 87 percent of all target quality levels. Target outcomes are jointly agreed upon by each hospital and the health insurer using benchmarks established by the Centers for Medicare & Medicaid Services, the Leapfrog Group, the Joint Commission on the Accreditation of Healthcare Organizations, the Institute for Healthcare Improvement, and others.

Four areas are targeted for improvement:

  • Clinical Outcomes – Focused on improvements in heart attack care, heart failure and pneumonia care
  • Patient Safety – Focused on reductions in hospital-acquired infections, improved medication reconciliation processes, surgical care and National Quality Forum Safe Practices
  • Patient Perception of Care and Patient Satisfaction – Focused on a hospital’s use of a national survey tool
  • Efficiency – Focused on generics utilization, length of stay, and readmissions

"Univera Healthcare has continued to advance the program whereby hospitals are now required to measure surgical and clinical care composites as hospital contracts open for negotiation,” said Frank. “It is anticipated that this focus will further drive performance improvement to national performance levels in important measures as identified by CMS.*"

Relevance in upstate New York 

According to the most recent data on hospital-acquired infections available from the Centers for Medicare & Medicaid Services, there were an estimated 24,000 hospital-acquired infections in upstate New York in 2010, and more than 1,000 deaths were likely to have occurred as a result.

*The Centers for Medicare & Medicaid Services is the US federal agency which administers Medicare, Medicaid, and the Children's Health Insurance Program.


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