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Leapfrog Hospital Rewards Program™ (LHRP)
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Horizon BCBSNJ Hospital Rewards Program
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Complete Details Available:
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Complete Details Available:
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Leapfrog Hospital Rewards Program web site
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Horizon BCBSNJ Hospital Rewards Program
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Clinical Areas:
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Clinical Areas:
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- Coronary Artery Bypass Graft (CABG)
- Acute Myocardial Infarction (AMI)
- Percutaneous Coronary Intervention (PCI)
- Community-acquired pneumonia
- Deliveries/newborn care
Performance assessed and rewarded separately for each of these five clinical areas.
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Based on Centers for Medicare & Medicaid Services' core measures:
- Acute Myocardial Infarction (AMI)
- Heart Failure
- Community-acquired Pneumonia
- Prevention of surgical-site infections
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Quality Measures:
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Quality Measures:
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- Applicable sections of the Leapfrog Hospital Quality and Patient Safety Survey
- Applicable JCAHO Core Measures
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- Based on Joint Commission on Accreditation of HealthCare Organizations' (JCAHO) patient safety measures
- The New Jersey Infection Prevention Partnership (MedMined or comparable vendor)
OR
- IHI 100,000 Lives Campaign
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Efficiency Measures:
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Efficiency Measures:
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- Severity adjusted average length of stay (ALOS) for routine care days and special care days*
- Re-admission rate to same facility within 14 days
* For deliveries/newborn care (ALOS for special care days is not measured)
The following indicators have been added by Horizon BCBSNJ, which will measure their results:
- Patient satisfaction outcomes
- Timeliness of electronic claims submission
- EDI percentage rate
- Percent error rate on notice of admission
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- Patient satisfaction outcomes
- Timeliness of electronic claims submission
- EDI percentage rate
- Percent error rate on Notice of Admission
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Data Sources:
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Data Sources:
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- Leapfrog Hospital Quality and Patient Safety Survey
- Core Measure Vendor (CMV)
- Applicable core measures sent to LHRP™ data aggregator
- Efficiency measure collected, severity adjusted and sent to LHRP™ data aggregator
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- JCAHO Survey - Patient Safety Measures *
- CMS Core Measure Data *
- Patient Satisfaction Outcomes **
- New Jersey Infection Prevention Partnership or IHI 100,000 Lives Campaign **
* Collected by Horizon BCBSNJ from Web site or from Horizon BCBSNJ administrative data.
** Outcomes are self reported by hospital to Horizon BCBSNJ.
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Data Submission Requirements:
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Data Submission Requirements:
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- Leapfrog Hospital Quality and Patient Safety Survey
- Send JCAHO and efficiency data through CMV
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- Patient safety outcomes
- NJ Infection Prevention Partnership outcomes or IHI 100,000 Lives Campaign
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Initial Data Submission Deadlines:
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Initial Data Submission Deadlines:
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Approximate Resources Necessary:
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Approximate Resources Necessary:
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- Leapfrog Survey: 3 days
- JCAHO and efficiency data varies based on CMV
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- Current Quality Improvement/Process Improvement resource - 1 day
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Participation Costs:
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Participation Costs:
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- 1 clinical area: $1,000/year
- 2 clinical areas: $1,350/year
- 3 clinical areas: $1,700/year
- 4 clinical areas: $2,050/year
- 5 clinical areas: $2,400/year
* Additional fees may be assessed by CMV
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Financial Opportunity:
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Financial Opportunity:
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Licensed Bed Size
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Maximum Reward
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Hospitals with 400 or more beds
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$175,000
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Hospitals with more than 200 beds but less than 400 beds
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$150,000
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Hospitals with less than 200 beds
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$125,000
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Licensed Bed Size
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Maximum Reward
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Hospitals with 400 or more beds
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$150,000
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Hospitals with more than 200 beds but less than 400 beds
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$125,000
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Hospitals with less than 200 beds
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$100,000
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