Highmark's Pay-For-Performance Program Reduces Infections, Boosts Preventive Care

Health insurer Highmark, based in Pittsburgh, has posted the results of its pay-for-performance program from fiscal year 2011, according to a company news release.

Highmark launched its Quality BLUE pay-for-performance program in 2002 with six hospitals. By fiscal year 2011, program participation grew to 63 hospitals and today includes 81 hospitals.

Major findings include the following:

• Seventy-six percent of female members aged 42-69 received mammography screening for breast cancer from Highmark providers in the past two years — 9 percent more than the national average.  

• Seventy-two percent of office-based physicians in the program use electronic prescribing compared to 36 percent nationally.

• An estimated 351 cases of MRSA with a care cost savings estimated between $9.5 million-$12.2 million were eliminated during the past four years of the program.

• An estimated 1,535 central line associated bloodstream infections were eliminated in all nursing units, not just intensive care units, during the last five years, saving potentially 184-384 lives.

Related Articles on Pay-for-Performance:

NYU Langone Strikes Pay-For-Performance Deal With BlueCross BlueShield
Pittsburgh's West Penn Allegheny, UPMC Shift From Traditional Payment Models
Pay-for-Performance Failed to Find Racial, Ethnic Disparities in Mass. Medicaid

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