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Paying for Results

Wellpoint, parent of several large Blue Cross plans including Anthem, Empire and BCBSGA have announced a major change in the way they will compensate hospitals for care. Wellpoint companies operate in 14 states and cover 34 million people.

In recent years, it has raised its payments to those hospitals by an average 8% a year.
Under the new system, the company will pay increases only to hospitals that score high enough on a test based on 51 indicators of treatment quality. The indicators include whether the facility tries to prevent patients from relapsing after they leave the hospital, whether it follows a safety checklist and how satisfied the hospital’s patients say they are with their treatment.

Facilities with poor scores won’t receive a payment boost.


I believe the medical term for that is flatline.

The WellPoint formula for measuring quality of care is based 55% on health outcomes, 35% on patient-safety measures and 10% on patient satisfaction.


Real accountability. What a novel idea. Now if only taxpayers could do the same with government officials . . .

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