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Partnering with Health Leaders to Transform How Patient Health Care Is Managed and Paid for in Michigan

Blue Cross Blue Shield of Michigan has always been committed to helping ensure that everyone has access to quality, affordable health care.  But we share our members’ and customers’ concerns that the cost of care needs to be more manageable.

As a nonprofit mutual insurer, our members and customers are at the center of everything we do.  We listen to their concerns and respond in meaningful and sustainable ways. A primary concern is the affordability of health insurance.

Our customers understand that the cost of health insurance reflects the cost of health care.  They’ve told us they want to pay for care that works – not pay for services that don’t.  Our members want to achieve optimal health and be able to afford quality insurance coverage.

That’s why today, I’m proud that together with Ascension Michigan, Henry Ford Health System, Michigan Medicine, Oakland Southfield Physicians, The Physician Alliance, Trinity Health-Michigan and United Physicians, we are announcing Blueprint for Affordability, a new payment relationship through which accountability for quality, patient outcomes, cost and efficiency are shared by all.

Blueprint for Affordability facilitates a high-quality, affordable health care delivery system where members get the care they need, in the right setting, from providers who work together and coordinate their care.

These seven major Michigan health organizations represent roughly 30 percent of Blue Cross’ payments for member care in Michigan.  The agreements will be effective January 1, 2020 and will cover Blue Cross Commercial PPO and Medicare Advantage PPO plans.

Since 2005, through our Value Partnerships programs, many doctors and hospitals statewide have been working together to improve the way health care is delivered. This has made a significant impact on the quality and safety of medical and surgical care. These collaborations have saved $2.2 billion in costs because patients are better able to get the care they need from their doctor’s office before conditions escalate, and because physicians have worked together to improve the delivery of care. As a result, Blue Cross has  been able to lower our insurance rates for small businesses nine times in recent years.

These are all great results, but we need to do more. Despite the progress we’ve made in improving quality and lowering cost, financial risk is still born primarily by those who pay for health care – not those who deliver it. Blueprint for Affordability is the next step in our evolution away from the fee-for-service model and toward a system that prioritizes value and quality.

We applaud these health leaders for being at the forefront of this next great leap in the payment reforms we have long promoted through initiatives such as the Physician Group Incentive Program, the Patient-Centered Medical Home, and Value-Based Hospital Contracting.

We also intend to continue to engage other physician organizations and health systems in Michigan to join us in this change.

This evolution is essential to successfully address the affordability concerns of our customers and members and it continues the value-based efforts that have been part of our strategy for 15 years.

For more information, I encourage you to visit BlueprintForAffordability.com.

Photo credit: Asawin_Klabma

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