BCBSSC’s Rewarding Excellence Program Adds Advance Care Planning to 2020 Measures

Staff Report From South Carolina CEO

Wednesday, November 7th, 2018

BlueCross BlueShield of South Carolina recently released its 2020 Rewarding Excellence Program measures and thanks to the efforts of SCHA, the SC Coalition of Care for the Seriously Ill and others, advance care planning was added to the program for the first time.

The Rewarding Excellence Program has become the method for providers to qualify for hospital contractual rate increases and is part of a sea change in the healthcare industry to value-based care. Instead of compensating hospitals for the number of procedures they perform, they are instead rewarded for the quality of care they provide. BCBSSC bases these rewards on how closely hospitals follow best practices and how well they care for patients—and that now includes advance care planning.

The ACP measures in the program are identical to the ones currently being used by hospitals participating in the Advance Care Planning grant from the BCBSSC Foundation which is supported by The Carolinas Center. SCHA and the other members of the SC Coalition for the Care of the Seriously Ill (SC CSI) are collaborating on the work under this grant to improve the quality of and accessibility to ACP conversations. The idea is to have these quality conversations lead to ACP documents that are clear, accessible and honored through shared decision making for all South Carolinians. The ACP measures will help SC hospitals provide care that is congruent with a person’s advance care planning document and will help hospitals improve their processes to honor a person’s wishes. Hospitals participating in the ACP grant have conducted chart reviews regarding documentation of patient-clinician discussions about the patient’s wishes regarding end of life care and have examined how the accessibility and utilization of a patient’s advance care planning documents are guiding medical treatment.

Few, if any, states have incorporated these types of ACP measures into their commercial insurance incentive programs, so SCHA and SC CSI are excited to build on the work currently being done under the ACP grant which will now be spread to all hospitals in the state through the 2020 Rewarding Excellence Program measures.