Children’s Hospital Colorado, Anthem pilot value-based care program

Denver-based Children’s Hospital Colorado partnered with Anthem Blue Cross and Blue Shield to pilot a hospital incentive program based on clinical quality outcomes.

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Under the hospital incentive program, Children’s facilities contracted with Anthem will see a portion of their reimbursement tied to performance on quality indicators.

Some of the pediatric quality indicators include surgical site infection outcomes for spinal fusions, neurological shunt placements and cardiothoracic procedures. The program will also have guidelines for asthma, bronchiolitis and sepsis populations, and require appropriate imaging for patients with confirmed appendicitis presenting at the emergency department.

Jena Hausmann, president and CEO of Children’s Hospital Colorado, said in a statement, “This program is both Anthem’s and Children’s Colorado’s first-ever hospital-based pediatric quality program.” Anthem will look into expanding the value-based program to other markets depending on the result of its pilot with Children’s.

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