Blue Cross Blue Shield of Michigan is managing health care costs while improving the quality of health care members receive. Value Partnerships is a collection of patient safety, clinical quality and care process efforts that make health care work better in Michigan. Through Value Partnerships, we encourage doctors and hospitals to work more closely together to help Michigan residents stay healthier and avoid costly emergency room visits. Value Partnerships has prevented about $2.2 billion in health care costs over the past 10 years due to its various initiatives. Of course, many of our cost-savings efforts don’t easily translate to lower out-of-pocket costs for members year over year. But it’s important to understand that our Value Partnerships efforts are keeping costs from rising as much as they otherwise would have. At Blue Cross, we call it “bending the benefit cost trend” and it’s something we’re doing across multiple platforms. Here’s a look at some of the many ways Blue Cross is working to keep health care costs as low as possible for our members:
- Helping members get and stay healthy. At the heart of any effort to lower health care costs is helping to keep members healthy so they require less health care. That’s why we’ve launched a variety of programs, in addition to Value Partnerships, that are focused on our members’ total well-being — both their mental and physical health. For example, ahealthiermichigan.org, one of our social media blogs, offers a host of tips for living a healthier life, from reducing stress to coping with back pain. We also offer the Blue Cross® Virtual Well-Being Program to help everyone learn how to improve their overall well-being and resilience.
- Choosing the right place for care. We educate members about how to select the right place for care. For example, the ER — one of the most expensive sites for care — isn’t appropriate for most conditions. Other care options, such as your primary care doctor, retail health clinics, urgent care center or the 24-Hour Nurse Line, may better meet your needs and save you money.
- Rewarding providers for good patient outcomes. We reward our health care providers — both hospitals and doctors — for achieving good patient outcomes, not simply for performing certain services. That helps you stay healthy and avoid costly or duplicate services.
- Monitoring prescription drug costs. Our pharmacists use analytics, reports, clinical reviews and other means to ensure that the rising cost of drugs doesn’t significantly impact premiums.
- Holding the line on specialty drug costs. Through drug utilization management programs, we help to ensure the appropriateness of drugs for our members. We also work to promote lower-cost treatment alternatives.
- Managing complex health conditions. We have a comprehensive array of care management programs that help members with complex health conditions get the support they need to improve their care and reduce the costs associated with their conditions.
- Offering rewards for choosing cost-effective care. A new program being offered to 600,000 commercial PPO group members will give them tools to shop for care, compare costs and choose health care services to meet their needs. The program, called Blue Cross RewardsSM, will also allow select members to potentially reduce their out-of-pocket expenses and earn e-gift cards for visiting cost-effective providers.
- Letting members choose their cost-share level. Our Blue Cross® Physician Choice PPO program lets members decide what cost-share level they want to pay based on where they choose to get care.
- Finding care centered on you. Our Patient-Centered Medical Home program, a key element of Value Partnerships, is helping members stay healthier, get better care and go to the ER less, reducing expenses.
- Identifying high-quality providers nationwide. Our Blue Distinction Total Care program identifies value-based programs across the country. BDTC doctors, hospitals and clinical care teams are outperforming other providers in key health care quality and patient health metrics.
While the majority of the programs mentioned in this post apply to all members, we encourage members to check their benefits to determine eligibility. More from MIBluesPerspectives:
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