Children's Hospital Colorado, Anthem Blue Cross and Blue Shield collaborate to pilot value-based payment model to improve patient outcomes

Monday, May 7, 2018 Child Health News
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DENVER, May 7, 2018 /PRNewswire/ -- Children's Hospital Colorado (Children's Colorado)

and Anthem Blue Cross and Blue Shield (Anthem) have partnered to pioneer a new version of Anthem's Quality-In-Sights®: Hospital Incentive Program (Q-HIP®) specifically focused on the unique care provided by children's facilities
contracted with Anthem.

Q-HIP is Anthem's industry-leading, value-based reimbursement program introduced in 2003, through which participating hospitals are eligible to receive incentives based on clinical quality delivered to Anthem's health care consumers. This new program launch at Children's Colorado allows Q-HIP to expand outside of its traditional short-term, general acute-care facility footprint. Specifically, the pilot will tie a portion of Children's Colorado's future reimbursement increases at-risk on performance against the program scorecard.

The new Q-HIP for Children's Facilities focuses on a number of key areas important to pediatric populations:

  • Surgical Site Infection (SSI) outcomes for specific procedures including spinal fusions, neurological shunt placements (primary, secondary and revision), and cardiothoracic procedures.
  • Implementing evidence-based clinical care guidelines for specific patient populations, such as those with asthma, bronchiolitis and sepsis.
  • Appropriate imaging utilization in patients with confirmed appendicitis presenting through the emergency department.

"Historically, payors have applied adult metrics to pediatric facilities, which clearly could not be aligned with the most important health care initiatives and goals for kids around safety, clinical effectiveness, outcomes and patient experience," said Jena Hausmann, president and CEO of Children's Hospital Colorado. "This program is both Anthem's and Children's Colorado's first ever, hospital-based pediatric quality program, creating a unique partnership between a major national payor and a child health system to ensure the best possible outcomes for our children and families."

"At Anthem, we believe partnerships that reward high quality care will improve patient safety, lead to better health outcomes and protect affordability," said Janet Pogar, vice president of provider solutions for Anthem Blue Cross and Blue Shield in Colorado. "We value the relationships we have with care providers and recognize that together we can work to improve the health care system for consumers."

Anthem expects the Q-HIP for Children's Facilities pilot to evolve as initial results are available through the collaboration with Children's Colorado and hopes to expand the model to children's facilities in other markets in the future.

About Children's Hospital ColoradoChildren's Hospital Colorado is a leading pediatric network 100 percent dedicated to the health and well-being of children, adolescents and young adults. Consistently acknowledged as one of the nation's top pediatric hospitals by U.S. News & World Report, Children's Colorado is recognized nationally and internationally for its medical, research, education and advocacy programs. It is at the forefront of research in childhood disease and pioneering treatments that are shaping the future of pediatrics, as well as offering everyday care for kids throughout Colorado and surrounding states. Founded in 1908, Children's Colorado offers a full spectrum of family-centered care at its urgent, emergency and specialty care locations throughout Metro Denver and Southern Colorado, including its location on the Anschutz Medical Campus. Scheduled to open in early 2019, the new Children's Hospital Colorado, Colorado Springs will be the first pediatric-only hospital in southern Colorado. For more information, visit, or connect with us on Facebook and Twitter.

Children's Hospital Colorado complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-720-777-9800. CHÚ Ý: N?u b?n nói Ti?ng Vi?t, có các d?ch v? h? tr? ngôn ng? mi?n phí dành cho b?n. G?i s? 1-720-777-9800

Contact: Natalie Goldstein, Children's Hospital Colorado 720-777-3970


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SOURCE Children’s Hospital Colorado

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