BCBS of Rhode Island Ties 20% of Hospital Reimbursements to Quality

Peter Andruszkiewicz, CEO of Blue Cross & Blue Shield of Rhode Island, recently explained that in the company's 2012 contracts with Rhode Island hospitals, roughly 20 percent of reimbursements are based on quality measures and readmissions, according to a Providence Business News report.

Mr. Andruszkiewicz, UnitedHealthcare of New England CEO Stephen Farrell and Tufts Health Plan of Rhode Island CEO James Roosevelt Jr. spoke at a health insurance conference session in Rhode Island to answer how their organizations will try to reduce healthcare costs.

Mr. Farrell said UnitedHealthcare will support value-based care measures and evidence-based medicine — in other words, a shift toward pay-for-performance and away from fee-for-service. He also said cost savings can be realized in healthcare when hospitals, insurers and patients increase compliance, improve education and reward providers who "produce the best outcomes," according to the report.

Similar to UnitedHealthcare's and BCBS of Rhode Island's plans, Mr. Roosevelt said Tufts Health Plan would be moving toward a global payment model that pays hospitals and other providers based on reducing volume and hospital stays but increasing patient preventive care.

More Articles on Hospital-Payor Relationships:

Private, Government Payors Are Top Financial Concerns for Hospital Executives

5 Largest Health Insurers Release 2011 Financials

More Insurers Shift High Out-of-Network Costs on Patients

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