Expansion of Risk-Sharing Model Highlights Importance of Coordinated Care Amid Pandemic Challenges 

Todd Van Tol

| 2 min read

Senior Vice President, Health Care Value

Two doctors looking at results
The past year has tested and stretched health care organizations to their limits, with staff at all levels rising to meet the dynamic challenges of care delivery brought about by the COVID-19 pandemic. Despite these challenges, it’s clearer now, more than ever, that improving patient care and lowering costs are goals we must continue to strive for. Since we announced our Blueprint for Affordability program in December 2019 we’ve made great strides in the right direction. Through a transformative, risk-sharing model, Blueprint encourages providers to better coordinate care. This approach has proven vital during the current health crisis as patients navigate new modes of care driven by shutdowns and social distancing practices. Seven new partners have recently joined the program, extending its reach in mid-, west-, and southeast Michigan. A total of 21 health organizations are now participating, representing roughly 38% of the total commercial preferred provider organization (PPO) and 42% of the Medicare Advantage PPO market. Blueprint builds on years of collaboration and partnership with health care providers statewide. Value Partnerships programs have improved health care quality in Michigan and have helped avoid $2.2 billion in costs over the last decade. Blueprint’s value-based payment model ups the ante by establishing annual cost-of-care targets and clinical quality benchmarks for health organizations that come on board. The risk-sharing agreement puts a portion of health organizations’ (doctors’ offices, hospitals, etc.) payment on the line. Organizations that meet cost and quality targets will share in additional financial rewards. When targets aren’t met, a rebate will be issued to Blue Cross from the provider for a portion of the overage. The fact that health care providers are joining Blueprint and fundamentally shifting the way they get paid during a pandemic means they see value in our vision for the future state of doctor-patient-carrier relationships. They see the bigger picture and understand that this model will ultimately lead to more predictable costs and improved quality of care for their patients. Learn more at Blueprintforaffordability.com. Related:
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