To encourage the use of publicly available quality data for the improvement of hospital care, the Blue Cross and Blue Shield Association announced yesterday a new national pilot program that will provide quarterly performance reports to hospitals and employers. The information represents an important first step toward helping consumers receive more consistent, effective care, the association said.
The Network Hospital Measurement program will use 18 established evidence-based measurements, some of which are surprisingly simple, such as ensuring a heart attack patient receives aspirin upon arrival at the hospital and that a pneumonia patient receives advice on quitting smoking. The reports are based on publicly available clinical measures from the CMS and the Joint Commission on Accreditation of Healthcare Organizations. They also include publicly available patient-safety measures from the Agency for Healthcare Research and Quality. The reports provide a framework for continued collaboration with Blues plans' network hospitals to help establish additional national benchmarks for high-quality care.
"Our healthcare system has vast amounts of information about quality and clinical evidence that if organized correctly and efficiently will result in better, more affordable care," said Scott Serota, the Blues association's president and chief executive officer. "Making this knowledge work to benefit providers, employers and consumers is the founding principle of the Blues' vision for a better future healthcare system."
National studies on healthcare quality have shown that the U.S. healthcare system lacks consistency in how scientifically proven care is delivered across the country. For example, a 2003 Rand Corp. study showed that patients get recommended, evidence-based care only about 55% of the time. The Blues pilot program creates no new reporting burden on healthcare providers, reorganizing the data into a more efficient information resource to support localized hospital efforts to improve care quality in collaboration with Blues plans.
"Our mission is to improve the consistency of these proven, evidence-based treatments at hospitals across the nation," Serota said. "This program is designed to collaboratively elevate the quality of care delivered by hospitals in the Blue Cross and Blue Shield Plans' networks."
Quarterly data reports are being provided by the JCAHO. "This initiative is creating a whole new way of looking at quality data," said Dennis O'Leary, M.D., the JCAHO's president and CEO. "The Blues are taking existing quality data and adding context, creating a valuable tool for hospitals that can help them provide more effective care for their patients."
Eighteen Blues companies, representing more than 80% of the 93 million Blues subscribers, are participating in the program. Collectively, 40 independent, locally operated Blues companies contract with more than 90% of all physicians in the country and 80% of all hospitals.