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New Blue Cross And Blue Shield Association Quality Initiative

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CHICAGO – October 18, 2005 – To encourage the use of publicly available quality data for the improvement of hospital care, the Blue Cross and Blue Shield Association (BCBSA) today announced a new national Network Hospital Measurement pilot program that will provide quarterly performance reports to hospitals and employers. This information represents an important first step toward helping consumers receive more consistent, effective care.

The reports are based on publicly available clinical measures from the Centers for Medicare and Medicaid Services and the Joint Commission on Accreditation of Healthcare Organizations. They also include publicly available patient safety indicator measures from the Agency for Healthcare Research and Quality. The reports provide a framework for continued collaboration with BCBS 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 P. Serota, BCBSA’s president and CEO. “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 our healthcare system lacks consistency in how scientifically proven care is delivered across the country. For example, a 2003 RAND Corporation study showed that patients get recommended, evidence-based care only about 55 percent of the time.

The BCBS national performance pilot adopts 18 established evidence-based measurements. Some of the measures are surprisingly simple, such as making sure that a heart attack patient receives aspirin upon arrival at the hospital, or that a pneumonia patient receives advice on quitting smoking.

The Network Hospital Measurement pilot creates no new reporting burden on healthcare providers. The program reorganizes the data into a more efficient information resource to support localized hospital efforts to improve care quality in collaboration with Blue Cross and Blue Shield companies.

“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 Joint Commission on Accreditation of Healthcare Organizations (JCAHO) the nation's predominant standards-setting and accrediting body in healthcare. An independent, not-for-profit organization, JCAHO has maintained state-of-the-art standards that focus on improving the quality and safety of care provided by healthcare organizations since 1951.

“This initiative is creating a whole new way of looking at quality data,” said Dennis O’Leary, president and CEO of JCAHO. “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 Blue Cross and Blue Shield companies, representing more than 80 percent of the collective 93 million Blue subscribers, are participating in the Network Hospital Measurement pilot program, drawing on the experience and strength gained from decades-long partnerships between healthcare professionals and Blue Cross and Blue Shield companies. Collectively, Blue Cross and Blue Shield companies contract with more than 90 percent of all physicians in the country and 80 percent of all hospitals.

The Blue Cross and Blue Shield Association is made up of 40 independent, locally operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for more than 93 million - nearly one-in-three – Americans.

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