Anthem Blue Cross and Blue Shield Joins with Nine Hospitals and the American College of Cardiology to Reward Quality.

Business Editors/Health/Medical Writers

RICHMOND, Va.--(BUSINESS WIRE)--Feb. 18, 2003

Anthem Blue Cross and Blue Shield is joining with nine hospitals and the American College of Cardiology (ACC) in a first-of-its-kind program to reward improvements in patient safety, patient health outcomes and patient satisfaction.

The three-year Quality-in-Sights Hospital Incentive Program (Q-HIP) will offer the nine participating hospitals financial incentives linked to specific performance objectives in three areas.

"With the creation of this program, Anthem is helping set a new standard for the delivery of health care," said Tom Snead, president, Anthem Blue Cross and Blue Shield, Southeast region. "This program will reward hospitals for implementing programs that help ensure the delivery of health care that is safe, effective and patient-centered."

Hospitals participating in the program are:

-- Bon Secours St. Mary's Hospital (Richmond)

-- Bon Secours Memorial Regional Medical Center (Mechanicsville)

-- Centra Health - Lynchburg General Hospital

-- Riverside Regional Medical Center (Newport News)

-- Sentara Norfolk General Hospital

-- Sentara Virginia Beach General Hospital

-- University of Virginia Health System (Charlottesville)

-- Virginia Commonwealth University (VCU) Health System (Richmond)

-- Winchester Medical Center

Anthem and the Virginia Chapter of the American College of Cardiology (VCACC) is collaborating with the participating hospitals to develop the program and the indicators that will measure success and determine performance payments. The result is a comprehensive program that is unique in Virginia and the nation.

"Our program is the first in the country to link all three components - patient safety, outcomes and satisfaction," said Richardson Grinnan, M.D., Anthem's head of quality support systems, "and that linkage is critical if we are going to drive real change in the health delivery system."

Patient Safety

The patient safety performance objectives are based on guidelines set by the Centers for Medicare and Medicaid Services, the Joint Commission on Accreditation of Health Care Organizations (JCAHO), and other respected organizations. Hospitals will be measured on objectives such as the adoption of JCAHO patient safety goals and implementation of patient safety initiatives, including computerized physician order entry, which has been shown to reduce serious medication errors by 88 percent.

Randolph Gordon, M.D, M.P.H., Bon Secours' senior vice president and chief medical officer, says the Quality-in-Sights program fits well with the priorities of his organization. "We have already identified quality improvements as the top priority of our health system," he said. "We appreciate the opportunity to have input in the development of the program and look forward to building a strong partnership with Anthem to reduce errors while boosting safety and quality." A former state commissioner of health, Dr. Gordon says he is excited about "the payers and deliverers of health care uniting to help Virginia hospitals do a better job all across the system."

All-payer data will be utilized to assess performance in these critical areas. Hospitals will be responsible for the collection, documentation and submission of the data and a hospital executive will be asked to attest to the validity of the processes according to industry standards.

Quality/Health Outcomes

Q-HIP focuses on improving indicators of care for patients with three common conditions: heart disease, pneumonia and pregnancy. The VCACC and ACC will play a key role in helping hospitals understand how they can improve cardiac care, drawing on lessons learned from ACC's "Guidelines Applied in Practice (GAP)" program and its National Cardiovascular Data Registry(TM) (NCDR). Improvements in the use of beta-blockers after a heart attack, for example, could save as many as 18,000 lives a year nationally.

"Anthem's Q-HIP program helps hospitals overcome barriers to improving quality. Anthem's partnership with the VCACC recognizes that physician participation is critical for the program's success," said John Brush, M.D., F.A.C.C., who is leading the project for the VCACC.

Patient Satisfaction

Anthem will track patient satisfaction through a survey of its members that will include several health status questions as well. In this way, the relationship between improvement in care processes and health outcomes and patient satisfaction can be linked.

A program that connects these three components is a "win-win situation in my mind," says Ron Clark, M.D., chief medical officer of the VCU Health System. "As health care providers, we always strive to do the right thing for our patients. The reality is this sometimes costs more in terms of putting in place new structures and processes to support a better way of delivering services. While we have had an active and robust quality improvement program for years, the increased reimbursement from Anthem will allow us to accelerate the timeline for achieving some of our goals."

The Anthem Blue Cross and Blue Shield companies provide health care benefits to more than 11 million people. Anthem Blue Cross and Blue Shield is a subsidiary of Anthem Inc. (NYSE: ATH); both are independent licensees of the Blue Cross and Blue Shield Association. Anthem is the Blue Cross and Blue Shield licensee for Indiana, Kentucky, Ohio, Connecticut, New Hampshire, Colorado, Nevada, Maine and Virginia, excluding the immediate suburbs of Washington, D.C. More information about Anthem is available at www.anthem.com.

The American College of Cardiology is the leading medical society and teaching institution for the nation's cardiovascular health care specialists. Its mission is to foster optimal cardiovascular care and disease prevention by providing professional education, promoting research, leading the development of standards and guidelines and contributing to the health care policy debate. More information about ACC is available at www.acc.org.