Highmark's Hospital Pay-for-Performance Program Demonstrates Impressi...( Model Program Saves Money and ...),Health

Model Program Saves Money and Improves Quality of Health Care

PITTSBURGH, Oct. 11 /PRNewswire/ -- During the past year, Highmark has worked with select hospitals in Western Pennsylvania as part of its pay-for- performance program called QualityBLUE to significantly reduce central line- associated bloodstream infections.

Central lines are used to monitor patient status and deliver medication and nutrition to critically ill patients through vessels that lead directly to the heart. Bacteria introduced through these lines can lead to life- threatening infections. The national average, is five infections per 1,000 line days for intensive care unit patients. The average hospital-wide rate for hospitals in the QualityBLUE program was only 1.5 per 1,000 line days.

While there were 214 such infections at QualityBLUE hospitals in the past year, had they occurred at the national average rate, there would have been a potential of 1,115 infections. At an estimated cost of $36,000 per case, that represents a potential savings to the health care system of more than $32 million.

"There are numerous areas which participating hospitals and Highmark focus, but this specific measure really shows the progress the program is making," said Michael Madden, M.D., medical director of medical performance management programs for Highmark. "These hospitals are safer for patients, and there is a significant cost savings. The QualityBLUE program is really making a difference when it comes to quality care for our members."

The Highmark QualityBLUE hospital pay-for-performance program began in fiscal year 2002 with six hospitals. Today, 29 hospitals participate in the program in Western Pennsylvania, and the program was recently expanded and now includes one hospital in Central Pennsylvania, with further expansion projected. Since the inception of the program, the number of hospital QualityBLUE participants has grown to encompass more than 60 percent of High
'/>"/>