Leapfrog Initiative Rewards Hospitals

Thousands of consumers, employers and physicians are making use of hospital performance data gathered and published by the Leapfrog Group — a coalition of some 150 large businesses that purchase health care insurance and focus on reducing medical mistakes and improving health care quality. Part of its mission is to reward hospitals and physicians that make patient safety improvements.

The Leapfrog Group was established in 2000, largely in response to a 1999 Institute of Medicine report, “To Err is Human,” that uncovered the large number of preventable medical errors that occur each year in hospitals.

The results of the Leapfrog Group’s hospital surveys, which are accessible online at www.leapfroggroup.org/cp, are getting the attention of both the health care community and many consumers. The program has already received progress reports on safety improvements from about 20 percent of the nation’s nonfederal urban acute-care facilities.

“This effort has quickly grown into a mature program,” said Tom Granatir, Humana’s senior advisor for health plan policy. “Not only are we seeing an increasing number of hospitals participating, but the information they provide — and which the Leapfrog Group makes available — is being accessed by more consumers and physicians who want the data to make wiser and more informed decisions about hospital use.”

Financial rewards in new program

Leapfrog’s latest initiative — the Leapfrog Hospital Rewards Program — gives health plans and purchasers a means to provide financial rewards to hospitals that demonstrate higher performance or make measurable improvements in five clinical areas that represent a significant proportion of hospital admissions and expenditures among the commercially insured population:
• Coronary artery bypass graft
• Percutaneous coronary intervention
• Acute myocardial infarction
• Community acquired pneumonia
• Deliveries and newborn care

Participating hospitals, which include several in Humana regions, will be evaluated by the Leapfrog Group in four tiers, based on quality and resource-use measures. Potential rewards will be calculated separately for each of the conditions in which the hospitals choose to participate.

Some Leapfrog coalition members are already devising reward systems for hospitals, based on current hospital survey data. These may include steering employees to providers who implement safety standards to offering financial rewards, such as higher reimbursement to providers.

“Humana continues to support the Leapfrog initiative, and we encourage hospital leaders to participate by submitting their institution’s information to the Leapfrog surveys,” Granatir said. “ … This initiative is maturing and becoming part of the mainstream with efforts like the American Hospital Association’s voluntary reporting initiatives and the National Quality Forum’s efforts to set hospital performance measures.”

Humana also has initiated several pilot programs aimed at improving hospital care. One of those programs provides Baptist Memorial Health Care in Memphis, Tennessee, with fully funded nursing education grants in exchange for Baptist’s commitment to meet improvement goals. Several of Humana’s goals for Baptist Memorial are aligned with the Leapfrog Group’s standards.

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