Children’s Hospital Colorado, Anthem Blue Cross and Blue Shield collaborate to pilot value-based payment model to improve patient outcomes

May 7, 2018

Children’s Hospital Colorado (Children’s Colorado) and Anthem Blue Cross and Blue Shield (Anthem) have partnered to pioneer a new version of Anthem’s Quality-In-Sights: Hospital Incentive Program (Q-HIP) specifically focused on the unique care provided by children’s facilities contracted with Anthem.

Q-HIP is Anthem’s value-based reimbursement program introduced in 2003, through which participating hospitals are eligible to receive incentives based on clinical quality delivered to Anthem’s healthcare consumers. This new program launch at Children’s Colorado allows Q-HIP to expand outside of its traditional short-term, general acute-care facility footprint. Specifically, the pilot will tie a portion of Children’s Colorado’s future reimbursement increases at-risk on performance against the program scorecard.

The new Q-HIP for Children’s Facilities focuses on a number of key areas important to pediatric populations:

  • Surgical Site Infection (SSI) outcomes for specific procedures including spinal fusions, neurological shunt placements (primary, secondary and revision), and cardiothoracic procedures.
  • Implementing evidence-based clinical care guidelines for specific patient populations, such as those with asthma, bronchiolitis and sepsis.
  • Appropriate imaging utilization in patients with confirmed appendicitis presenting through the emergency department.

Anthem expects the Q-HIP for Children’s Facilities pilot to evolve as initial results are available through the collaboration with Children’s Colorado and hopes to expand the model to children’s facilities in other markets in the future.

PR Newswire has the full release

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