Boosting healthcare quality. Reducing costs.
Safer, higher-quality, cost-effective health care.
Value Partnerships is a collection of programs among Blue Cross, physicians and hospitals across Michigan that make health care work better for everyone.
It is a unique, collaborative model that enables robust data collection and fosters the sharing of best practices, so health professionals can improve patient outcomes.
It is value-based, outcomes-based health care.
It is a movement away from the fee-for-service model that pays providers for every service regardless of its effectiveness. Value Partnerships initiatives pay health care providers for successfully managing their patients’ health.
These results moderate health costs – saving nearly $2.2 billion over the last decade because repeated tests were avoided, complications and errors were reduced, ER visits and hospital stays were prevented, and care was coordinated.
Value Partnerships began in 2005 with a handful of programs focused on quality improvement in the primary care and surgical arena. Today, there are 45 initiatives encouraging safety, quality, population health and coordination of care. Learn more.
Physician Group Incentive Program (PGIP)
Launched in 2005, PGIP connects approximately 40 physician organizations (representing 20,000 physicians) statewide to collect data, share best practices and collaborate on initiatives that improve the health care system in Michigan.
Participating physician organizations are evaluated and rewarded on transformation of health care delivery, quality metric performance, and performance enablement – all designed to improve overall value of care delivered while reducing total cost of care.
Patient-Centered Medical Home.
Patient-Centered Medical Home is a team-based, proactive model of efficient, cost-effective care centered around the patient. No other health plan led PCMH designation program has the size or results of the Blue Cross PCMH designation program.
Since 2009, PCMH doctors and their care teams have prevented disease, reduced hospitalizations and ER visits, tracked patient care, and better managed common and chronic medical conditions to keep patients healthy and avoid costs.
In Michigan, PCMH-designated practices are also designated as Total Care providers. Total Care is the nation’s largest integrated network of value‐based care providers. To find a doctor with Total Care designation use the Find a Doctor feature on bcbsm.com.
Provider-Delivered Care Management.
PCMH-designated practices provide personalized care management services for patients with chronic conditions or multiple, ongoing health needs. Patient care teams are assembled according to each patient’s needs, and may include nurses, nutritionists, counselors, psychologists, respiratory therapists, asthma educators, certified diabetes educators, social workers, pharmacists and community health workers. Services are coordinated with the care patients are already receiving from their doctor.
Health Information Exchange.
The Health Information Exchange Initiative supports physicians and physician organizations who participate in statewide data sharing through the Michigan Health Information Network Shared Services (MiHIN). Participants receive daily emergency room and inpatient admission, discharge, transfer alerts and medication information for their entire patient population. This enables physicians to follow up with their patients sooner, better coordinate care transitions, and reduce duplication of medications and therapies.
Collaborative Quality Initiatives
Collaborative Quality Initiatives address many of the most common and costly areas of surgical and medical care in Michigan. In each CQI, hospitals and physicians across the state collect, share and analyze data on patient risk factors, processes of care and outcomes of care, then design and implement changes to improve patient care.
The innovative approach has resulted in better quality and safety, improved outcomes, and more than $1.4 billion in health costs saved statewide. For more information, go to cqis.org
Current CQIs include:
- Anesthesiology Performance Improvement and Reporting Exchange (ASPIRE)
- Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2)
- Healthy Behavior Optimization for Michigan (HBOM)
- Michigan Hospital Medicine Safety Consortium (HMS)
- Inspiring Health Advances in Lung Care (INHALE)
- Michigan Anticoagulation Quality Improvement Initiative (MAQI2)
- Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI)
- Michigan Bariatric Surgery Collaborative (MBSC)
- Michigan Collaborative for Type 2 Diabetes (MCT2D)
- Michigan Emergency Department Improvement Collaborative (MEDIC)
- Michigan Mental health Innovation Network for Clinical Design (MI-MIND)
- Michigan Back Collaborative (MIBAC)
- Michigan Oncology Quality Consortium (MOQC)
- Michigan Radiation Oncology Quality Consortium (MROQC)
- Michigan Social Health Interventions to Eliminate Disparities (MSHIELD)
- Michigan Surgical Quality Collaborative (MSQC)
- Michigan Spine Surgery Improvement Collaborative (MSSIC)
- Michigan Society of Thoracic and Cardiovascular Surgeons (MSTCVS)
- Michigan Trauma Quality Improvement Program (MTQIP)
- Michigan Urological Surgery Improvement Collaborative (MUSIC)
- Michigan Value Collaborative (MVC)
- Obstetrics Initiative (OBI)
Blue Cross makes additional rewards available to physicians and hospitals for quality, cost and performance.
Hospital rewards include the Pay for Performance program which recognizes hospitals for improvements in quality, cost, efficiency, and population-health management.
Physician rewards include Value-Based Reimbursement, PGIP PO Reward Payments and the Performance Recognition Program, all rewarding physicians for clinical quality achievements and member outcomes.
- Patient adverse financial outcomes before and after COVID‐19 infection - Becker - 2023 - Journal of Hospital Medicine - Wiley Online Library
- Michigan Hospital Medicine Safety Consortium | HMS (mi-hms.org)
- How Collaboration Can Drastically Improve U.S. Health Care (hbr.org)
- Enlist Medical Specialists in the Drive to Improve Population Health (hbr.org)
- Helping hearts across Michigan (michiganmedicine.org)
- Statewide quality improvement project reduced excessive radiation treatments for bone metastases by 80% (michiganmedicine.org)
- Life after COVID-19 hospitalization: Statewide study shows major lasting effects on health, work and more (umich.edu)
- Too many COVID-19 patients get unneeded “just in case” antibiotics (umich.edu)
- Helping patients prep mind and body for surgery pays off | ScienceDaily