Highmark’s pay-for-value programs continue to reap health benefits for their members, according to Highmark Inc.’s 2014 Quality Blue program results. After four years of tracking hospital readmissions, the Quality Blue program has helped to avert 2,900 readmissions, with a potential cost savings of $27.7 million. Following eight years of monitoring health care-associated infections, Quality Blue has helped to prevent 5,630 infections, with a potential cost savings in the range of $34.8 million to $109.4 million.
In 2014 alone, the hospital-insurer collaboration helped to avert 754 readmissions, with a potential cost savings of $7.2 million. In addition, 1,267 health care-associated infections were prevented, resulting in a potential cost savings of $5.7 million.
The following are highlights of the Quality Blue program’s results as of December 31, 2014:
- The rate of returns to the emergency room within 48 hours of discharge decreased by nearly 7 percent.
- From 2011 to 2014, 30-day readmission rates decreased by more than 3 percent.
- Seven-day follow-up care after discharge for heart failure patients improved by 72 percent; for stroke patients, 17 percent.
- For end-of-life care, hospitals following protocols improved by nearly 44 percent.
- Elective labor inductions at less than 39 weeks gestation decreased by 37 percent. (Reducing early elective inductions can reduce harm to both mothers and babies.)
- Compliance with sepsis protocols improved by 37 percent. (Early detection of sepsis and quick intervention can reduce patient deaths.)
- Risk screening for pre-surgical anemia increased by 32 percent.
- Catheter-associated urinary tract infections (CAUTI) declined by 8 percent.
- Clostridium difficile infections (CDI, or C. diff) decreased by 40 percent. (CDI can lead to colitis and severe diarrhea.)
- Central line-associated blood stream infections (CLABSI) dropped by 31 percent.
- Outpatient surgical site infections (SSI) decreased by 37 percent; inpatient SSI declined by more than 4 percent.
Highmark’s 13-year-old Quality Blue hospital program has grown to include 102 hospitals.