Blue Cross Blue Shield of Michigan Extends Transformative Payment Model to Communities Across the State

Meghan O'Brien

| 4 min read

Doctor and nurse talking
CONTACT: Meghan O’Brien 313-549-9884 FOR IMMEDIATE RELEASE DETROIT, February 24, 2020 – Blue Cross Blue Shield of Michigan is expanding its transformative, risk-sharing payment relationship with health care providers across the state, putting patients at the center of their health care and holding the line on the skyrocketing growth of health care costs. The “Blueprint for Affordability” payment model began with seven major Southeast Michigan health organizations in December 2019. Now as seven more health organizations join Blueprint, payment relationships will extend across all of Michigan; reaching health care providers from the west side to mid-Michigan to the northern Lower Peninsula. “I am proud to welcome these provider organizations to our statewide partnership as we take a stand for quality and affordability in health care,” said Blue Cross Blue Shield of Michigan President and CEO Daniel J. Loepp. “The power and value in Blueprint for Affordability comes from everyone joining together to challenge the status quo. Now throughout the lower peninsula, people will benefit from higher quality health care at costs they can better manage.” The second group of health organizations signing on to risk-sharing agreements with Blue Cross include:
  • Affinia Health Network (Grand Rapids area)
  • Genesys PHO (Greater Flint)
  • Great Lakes OSC (Midland area)
  • Holland Physician Hospital Organization (Holland area)
  • Munson Healthcare Clinically Integrated Network (northern lower Michigan)
  • Northern Physicians Organization – Clinically Integrated Network (NPO-CIN) (Traverse City area)
  • St. Mary’s PHO (Saginaw area)
The Blueprint for Affordability value-based payment model is the next step in Blue Cross’ ongoing journey away from traditional fee-for-service payment. Under this new approach, annual cost targets to provide care to Blue Cross members and clinical quality benchmarks are set for each health system or physician organization and are tailored to account for each organization’s unique patient population. If an organization keeps its cost below target and meets its quality metrics, they will receive additional financial rewards from Blue Cross. But if costs cannot be kept within the target or quality metrics are not met, the organization will rebate Blue Cross, and ultimately its customers, a portion of the amount that was overspent. “These health care leaders are signing on to risk-sharing contracts that will disrupt the trend of rising health care costs,” Loepp said. “Thanks to the leadership, knowledge and tenacity of these health systems and physician organizations, costs will become more predictable for Blue Cross customers and the quality and efficiency of health care will improve for patients across the state.” These seven health organizations signing risk-sharing agreements with Blue Cross join a premier group of Michigan health systems and physician organizations in the Blueprint initiative, including Ascension Michigan, Henry Ford Health System, Michigan Medicine, Oakland Southfield Physicians, The Physician Alliance, Trinity Health Michigan and United Physicians. With Blueprint for Affordability, Blue Cross is incorporating enhanced data and reporting to ensure health organizations have the necessary tools, capabilities and resources to manage their patient populations more effectively and efficiently. Patients can expect increased quality of care from their providers, including fewer complications and rehospitalizations. As a result of care coordination that Blueprint for Affordability promotes, patients also will avoid unnecessary tests, scans and emergency room visits. Blue Cross and provider partners have been pioneering the shift to value-based care in Michigan since 2005. Through more than 50 Value Partnerships initiatives, including the nation’s leading Patient-Centered Medical Home program, Blue Cross saved $2.2 billion in medical costs. This has translated to nine premium reductions for small group customers over the past five years and moderation of rates in the individual and Medicare Advantage markets. For more information, visit Blue Cross Blue Shield of Michigan, a nonprofit mutual insurance company, is an independent licensee of the Blue Cross and Blue Shield Association. Blue Cross provides and administers health benefits to more than 4.7 million members residing in Michigan in addition to employees of Michigan-headquartered companies who reside outside the state. The company has been committed to delivering affordable health care products through a broad variety of plans for businesses, individuals and seniors for 80 years. For more information, visit and #### Photo credit: Hispanolistic
MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association