TRHMC Rewarded by Insurance Carriers for Quality Care

Monday, July 19, 2010

 Highmark Inc. and AmeriHealth Mercy Health Plan have recognized The Reading Hospital and Medical Center (TRHMC) for quality care and patient satisfaction.

For the last two years, TRHMC has participated in the Quality-Blue pay for performance program.  During the last fiscal year, the Hospital showed improvement in each of four selected indicator areas:

• Bloodstream infections associated with a central line
• Emergency Department throughput
• Readmissions
• Venous thromboembolisms

The scores for improvements in these areas, combined with the Hospital’s core measures and Hospital Consumer Assessment of Healthcare Providers & Systems results, earned TRHMC a score of 96.4% out of 100%, placing the Hospital in the highest possible reimbursement category. 

TRHMC earned an additional $1.4 million in reimbursement from Highmark Inc.

The Reading Health Dispensary (RHD) and the Children’s Health Center (CHC) received a combined total of $66,700 from AmeriHealth Mercy Health Plan for quality care.

Despite patients being in the 90th percentile for severity of illness, RHD was rated in the 95th percentile for its peer group for the care provided to its patients.  The Dispensary also did better than 85 percent of its peers in not sending patients to the Emergency Department (ED).

The Target Quality Measures for RHD included breast cancer screenings, cervical cancer screenings, comprehensive diabetic care, use of appropriate asthma medications, children’s access to primary care, and adolescent well care.

The CHC was found to be in the 85th percentile for its peer group for Target Quality Measures (use of appropriate asthma medications, children’s access to primary care, and adolescent well care).  In addition, the CHC did better than 95% of its peers in not sending patients to the ED.