A quality partnership: Anthem incentive program focuses on performance.

Elliot Hospital and Anthem Blue Gross and Blue Shield in New Hampshire have announced a multiple-year renewal of their contract, an agreement that also includes the Manchester hospital's continued participation in Anthem's Quality Hospital Incentive Program (Q-HIP), a "pay-for-performance" collaboration.

Other participants in Anthem's Q-HIP initiative include Catholic Medical Center in Manchester, Cheshire Medical Center in Keene, Concord Hospital, Dartmouth-Hitchcock Medical Center in Lebanon, Littleton Regional Hospital, St. Joseph Hospital in Nashua and Wentworth-Douglass Hospital in Dover.

"We're pleased to renew our contract with Anthem Blue Cross and Blue Shield in New Hampshire and to continue our quality partnership," said Douglas Dean, president and chief executive of Elliot Hospital.

For the past two years, the Elliot has been a member of Anthem's Q-HIP, which offers participating hospitals financial incentives linked to meeting specific performance objectives focused on improving patient safety, health outcomes and satisfaction. Q-HIP is part of Anthem Quality Insights, a series of quality recognition and health improvement programs targeting hospitals, primary care providers and specialty physicians.

"Our patients and their families expect and deserve quality health-care services," said Dr. Rick Phelps, executive vice president, clinical operations, at the Elliot. "The reality is this sometimes costs more in terms of putting in place new structures and processes to support a better way of delivering those services. While our hospital continually seeks ways in which to improve ourselves, our participation in Anthem's Q-HIP project allows us to accelerate the timeline for achieving some of our goals."

Anthem's Q-HIP focuses on evaluating institutional processes for patient safety, as well as specific indicators of care for patients with three common conditions: heart attack, heart failure and pneumonia. The new initiative is designed to help hospitals overcome barriers to improving quality. Hospital participants will be responsible for the collection, documentation and submission of data and a hospital executive will be asked to attest to the validity of the data and processes in accordance with industry standards.

Q-HIP performance objectives are based on safety and care processes adopted by such organizations as the Joint Commission on Accreditation of Healthcare Organizations, or JCAHO, the Leapfrog Group and other industry authorities. By employing nationally accepted and standardized safety and quality-of-care metrics, hospitals are encouraged to focus on improving their performance to meet or exceed goals while minimizing administrative burdens associated with reporting.

Patient safety, satisfaction

Performance indicators for heart attack heart failure and pneumonia match those already reported to organizations such as the Centers for Medicare and Medicaid Services. They include evidence-based interventions such as the use of aspirin and other heart-protective medications, smoking cessation advice, appropriate antibiotic administration and immunizations.

A patient's perspective on his or her hospital care is captured through the national standardized survey instrument called HCAHPS, or the hospital administered patient satisfaction survey. The survey helps to support improvements in customer satisfaction and quality-related activities.

Participating hospitals also are measured on objectives that include the adoption of JCAHO patient safety goals and implementation of patient safety initiatives, such as computerized physician order entry, which have been shown to reduce serious medication errors by 88 percent, said Richard Lafleur, medical director Anthem Blue Cross and Blue Shield in New Hampshire.

"Our commitment to collaboration has helped in many ways to redefine our relationship with physicians and hospitals," said Lafleur. "We believe that working together we can hdp to create a health-care delivery system that demonstrates that quality costs less."

Lafleur said the program "is the first in New" Hampshire to link all three components--patient safety, health outcomes and satisfaction. That linkage is critical if we are going to drive real change in the health care delivery system."