Twenty-five years ago, Blue Cross Blue Shield of Michigan partnered with five hospitals to launch the percutaneous coronary intervention registry, a collaborative effort to improve quality, cost and outcomes of angioplasty procedures. Since then, the initiative has grown into a statewide consortium of nearly 50 hospitals and 600 physicians, now called BMC2 (Blue Cross Blue Shield of Michigan Cardiovascular Consortium). BMC2 is comprised of three quality improvement projects:
- Percutaneous coronary interventions (BMC2 PCI)
- Vascular surgical procedures and carotid interventions (BMC2 Vascular Surgery)
- Michigan TAVR, a structural heart quality improvement initiative focused on transcatheter aortic valve replacement in collaboration with the Michigan Society of Thoracic and Cardiovascular Surgeons (MSTCVS).
Initiatives within BMC2 have reduced surgical site infections, bleeding and vascular complications, and have lowered patients’ risk of readmission and death. All projects collect, audit, and organize data, and report procedural variables and outcomes to individual physicians and participating hospitals. The collaboration across BMC2 overcomes the barriers of traditional market and academic competition. “What we have in Michigan is truly special. Every non-federal hospital in the state that performs PCI participates in BMC2 PCI,” said Hitinder Gurm, M.D., BMC2 and BMC2-PCI program director. “We have an entire network of hospitals, cath lab teams, physicians, nurses, quality departments, and Blue Cross Blue Shield of Michigan collaborating on the singular mission of improving safety and quality of care.” The success of BMC2 inspired additional collaborations between Blue Cross, hospitals and physicians across Michigan. Now 25 years later, more than 20 collaborative quality initiatives, or CQIs, have been formed. Each CQI focuses on a common and costly medical or surgical area that needs improvement, such as blood clot prevention, knee and hip replacement, general surgery, and prostate cancer. In each CQI, hospitals and physicians across the state collect, share and analyze data, then come together to discuss their findings, and design and implement changes to improve patient care. A 2015 analysis showed that a subset of five CQIs saved an estimated $1.4 billion in health costs due to decreased complications and improved patient outcomes. For BMC2, the very first CQI, the collaboration is robust. BMC2 also established a cross-site peer review process to evaluate the appropriateness and quality of specific interventions. “To check quality assurance, participating physicians review each other’s cases to assess the appropriateness and quality of the procedure. The cases are scored, and physicians receive comments from those who reviewed their cases,” said Peter Henke, M.D., BMC2 Vascular Surgery program director. “This allows us all a great opportunity for learning and improvement in a non-competitive environment.” “The robustness of the BMC2 provider community, the comprehensiveness of BMC2’s clinical data, the creation of best practices, and the open sharing of ground-breaking knowledge by consortium participants have fostered a unique environment where the positive impact of BMC2 is felt not only by cardiovascular patients in Michigan but across the world,” said James Grant, M.D., senior vice president and chief medical officer at Blue Cross Blue Shield of Michigan. More from MIBluesPerspectives: Photo credit: Getty Images