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Managing Health Care Costs with Value Partnerships

When businesses choose Blue Cross Blue Shield of Michigan as their insurance provider, they’re aligning themselves with an industry leader – a company that’s stemming the tide of rising health care costs in Michigan.

The company’s not-so-secret ingredient? Our nationally recognized Value Partnerships program – a collection of more than 50 initiatives that manage health care costs while improving the quality of patient care.

How does Value Partnerships accomplish this? By joining forces with hospitals and participating physicians across the state to find new and better ways to deliver health care.

You may have heard about several Value Partnerships efforts already. These include Collaborative Quality Initiatives and the award-winning Patient-Centered Medical Home (PCMH). In the recently released Value Partnerships annual report, Blue Cross Senior Vice President and Chief Medical Officer Dr. Thomas Simmer, shared his sentiments on the program:

“Our medical-home model is successful because it’s a trusted partnership between Blue Cross and more than 40 physician organizations statewide. The program benefits from the best thinking from physicians who know what really works in practice. And patients are getting better care with better outcomes.”

Here are two examples of how the PCMH program is making a difference:

  • 19 percent lower rate of ER visits for adults than undesignated practices
  • 17 percent reduction in hospital cost per member per month

Closely aligned with the PCMH program is Provider-Delivered Care Management, which enables PCMH-designated practices to provide ongoing care management services for patients with chronic conditions. An internal analysis of the program showed patients receiving care management services had:

  • 38 fewer ER visits per 1,000 people
  • 40 fewer inpatient admissions per 1,000 people
  • $144.17 lower per member per month medical costs

Blue Cross’ many quality initiatives are also reducing complications and avoiding costs. Our claims data showed these initiatives have led to higher quality and safety, as well as fewer complications, resulting in:

  • $1.4 billion total statewide health care cost avoidance, including $413 million in cost avoidance for Blue Cross, Blue Care Network and Medicare Advantage plans.

Results like these benefit more than just Blue Cross members and customers; they benefit all Michigan residents. Hospitals and physicians who incorporate Value Partnerships initiatives into their practices roll them out to all their patients — not just those with Blue Cross insurance.

What’s more, when people enjoy improved health outcomes and decreased complications, they make healthier, happier, more productive employees.

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Pam Berry is a senior writer at Blue Cross Blue Shield of Michigan

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