Anthem Blue Cross and Blue Shield in Ohio, Joint Commission Align Quality Recognition Criteria for Antibiotic Stewardship, Palliative Care Programs

Anthem is the first major insurer to offer an incentive to network hospitals that achieve Joint Commission Advanced Certification for Palliative Care

https://www.jointcommission.org

https://www.jointcommission.org

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CINNCINATI--()--The Joint Commission, the nation’s oldest and largest standards-setting and accrediting body in health care, announced today that Anthem Blue Cross and Blue Shield in Ohio (Anthem) now recognizes two new Joint Commission programs as eligible for incentives from the health plan’s Quality-In-Sights®: Hospital Incentive Program (Q-HIP®).

Q-HIP is Anthem’s industry-leading quality recognition program introduced in 2003, with nearly 100 hospitals participating across Ohio. Q-HIP facilities are eligible to receive incentives based on clinical quality delivered to Anthem members. With the two new recognitions, Anthem’s hospital incentive formula now offers six bonus measures, three of them associated with Joint Commission initiatives.

The new Joint Commission recognitions from Anthem and its sister health plans in 13 other states are:

  • Advanced Certification for Palliative Care, which meets a palliative care bonus measure that Anthem introduced to its Q-HIP Jan. 1. Through Q-HIP, Anthem and its affiliated health plans are the first to offer an incentive to network providers that achieve the certification. The Joint Commission’s Advanced Certification for Palliative Care recognizes hospital inpatient programs that demonstrate exceptional patient and family-centered care and optimize the quality of life for adult and pediatric patients with serious illnesses.
  • Antimicrobial Stewardship recognition, awarded to Anthem Q-HIP-participating hospitals that are surveyed by The Joint Commission after Jan. 1 and achieve initial or continued accreditation. Each year, more than 2 million people become infected with bacteria resistant to antibiotics and at least 23,000 people die as a direct result from these infections, according to the Centers for Disease Control and Prevention. These participating hospitals will automatically earn credit for evidence of an effective antimicrobial stewardship program. Previously, hospitals were required to submit extensive documentation for review and consideration by the Q-HIP program. This recognition will promote patient safety and quality of care and align hospitals and nursing care center accreditation programs with current recommendations from the CDC and other professional and scientific organizations.

“Anthem is to be commended for recognizing the value that Joint Commission certification and accreditation bring to participating hospitals and their health care teams in demonstrating the highest standards for quality and patient safety in palliative care and antimicrobial stewardship,” said Mark Pelletier, RN, MS, chief operating officer, Accreditation and Certification Operations, The Joint Commission. “The true beneficiaries are the patients in Anthem plans who receive care at the Joint Commission accredited and certified hospitals that are adhering to the antimicrobial standards and achieving Palliative Care Certification.”

“When we collaborate with hospitals on quality – and focus on rewarding providers for how well they do, not how much they do – our members benefit,” said Steve Martenet, president, Anthem in Ohio. “These additional certifications not only reward quality but they also reduce the administrative burden on our provider partners.”

The Joint Commission’s Integrated Care Certification was previously recognized by Q-HIP in 2016. More information on that recognition is available here.

The Joint Commission

Founded in 1951, The Joint Commission seeks to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The Joint Commission accredits and certifies more than 21,000 health care organizations and programs in the United States. An independent, nonprofit organization, The Joint Commission is the nation’s oldest and largest standards-setting and accrediting body in health care. Learn more about The Joint Commission at www.jointcommission.org.

About Anthem: Anthem Blue Cross and Blue Shield is the trade name of Community Insurance Company, an independent licensee of the Blue Cross Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Ohio is available at www.anthem.com.

Contacts

Jeff Blunt
Anthem Blue Cross and Blue Shield
(513) 336-4033
Jeff.Blunt@anthem.com
or
Elizabeth Eaken Zhani
The Joint Commission
(630) 792-5914
ezhani@jointcommission.org

Release Summary

The Joint Commission announced that Anthem Blue Cross and Blue Shield in Ohio and its 13 sister health plans now recognize two new Joint Commission programs for their Q-HIP pay-for-performance program

Contacts

Jeff Blunt
Anthem Blue Cross and Blue Shield
(513) 336-4033
Jeff.Blunt@anthem.com
or
Elizabeth Eaken Zhani
The Joint Commission
(630) 792-5914
ezhani@jointcommission.org