2022 Annual Report: Ready to Help Our Members & Customers
Blues Perspectives
| 5 min read
From offering exceptional care options for seniors, to new program offerings that provide personalized solutions and ways to save money on prescriptions and treatments – Blue Cross Blue Shield of Michigan is ready to help our members and customers achieve optimal health throughout their lives.
Innovative programs make care more personal and accessible
In 2022, our members gained access to new services and programs that offer innovative ways of accessing care that supports their whole health.
Responding to the increasingly urgent need for mental health care, Blue Cross and Blue Care Network expanded access in 2022:
- Mental health care is now available at primary care sites. More than 200 practices and 800 providers in Michigan have adopted the Collaborative Care model – a groundbreaking approach by Blue Cross to bring mental and behavioral health care into the primary care provider’s office.
- We expanded access to crisis services for behavioral health. We launched new care options for members under the age of 65 with urgent mental health needs or substance use issues to get prompt and appropriate treatment at participating facilities.
- We removed barriers to care by expanding virtual visit availability. More than 2,000 licensed therapists were added to our nationwide network through a virtual behavioral health provider.
Blue Care Network members have access to Michigan’s first end-to-end pharmacogenomics precision medicine program: Blue Cross Personalized Medicine℠ . A pilot program was offered to select members through the end of 2022. Providers use a patient’s genetic test results to help find the most clinically effective medication for them. This science-based approach helps doctors find the right drug more quickly, helping patients avoid a costly, and often disheartening, trial-and-error process.
In 2022 we expanded our successful diabetes management programto include prediabetes and hypertension management. The program assists and guides members through every step of their health care journey, including mental health.
We also offered new programs to customers and members to select starting in 2023:
- A new Virtual Primary Care plan for Blue Care Network members offers quick access to virtual visits with a primary care provider within days or minutes for urgent issues, with access to in-person care through BCN providers.
- We launched a new, comprehensive family building and maternity support solution that includes a personalized digital care app to help guide members on their journey through family planning, including different paths to parenthood, pregnancy, postpartum and pediatrics.
Lowering out-of-pocket pharmacy costs
Rising costs of prescription medications are a concern for our members and customers. From July 2021 to July 2022, the average price increase for drugs that exceeded the rate of inflation was 31.6% in the United States.
Our Pharmacy team at Blue Cross works diligently on solutions to address this growing concern. We work to provide our lowest-net cost strategy to our customers by choosing generics or lower-priced brands, when clinically appropriate, and by ensuring members get the right drug, at the right time. Thanks to interventions by the Blue Cross Pharmacy team, we can significantly lower pharmacy benefit costs through programs and negotiated manufacturer rebates.
In 2022, we completed a complex transition to a new pharmacy benefits manager with minimal disruptions to members. The transition improves member experience and will contribute to improved medication pricing for members in the long term. Offering pharmacy and medical benefits as an integrated solution allows for improved coordination of care for members – resulting in reduced medical costs, as unnecessary or redundant treatments are eliminated and health outcomes are improved.
Blue Cross offers innovative programs to help members manage the costs of their medications – from daily maintenance drugs to infusion treatments.
Infusion medication treatments for chronic conditions often use specialty drugs – which can be costly. By encouraging members to receive their infusion therapy at a location that’s more convenient for them – like at home, at a doctor’s office or a freestanding infusion center – we can lower-out-of-pocket costs for members. By receiving infusion treatments outside of a hospital setting, costs are 30% to 50% less.
Blue Cross and Blue Care Network members saved a cumulative $2.5 million on their prescriptions in 2022, thanks to a program that helps them refill their prescriptions on time. Through our Drug Adherence Discount Program, members earn discounts on their copays when they refill and pick up their prescriptions on time. So far, this program has resulted in a 45% decrease in member out-of-pocket costs for eligible drugs.
These initiatives are among the ways Blue Cross Pharmacy programs are ready to help members take the right medication at the right time, while saving money and providing value.
Exceptional care for seniors
Seniors can depend on exceptional Medicare Advantage plans from Blue Cross.
In 2022, the Centers for Medicare and Medicaid Services awarded Blue Care Network a 4.5-Star rating for our HMO Medicare Advantage Plan and awarded Blue Cross’ PPO plan a 4.5-Star rating for 2023. Star ratings measure the quality of health services received by beneficiaries enrolled in Medicare Advantage plans and assist beneficiaries in finding the best plan for them.
Also in 2022, we prepared to launch new plan offerings for our senior members to enroll in for the 2023 Medicare plan year. For Medicare members in Macomb, Oakland and Wayne counties, a new $0 premium health plan – BCN Advantage Local HMO– features lower copays, reduced deductibles and enhanced benefits, including $0 copays for primary care provider visits and $0 medical deductible. We also offered valuable enhancements for BCBSM’s Medicare Advantage plans with the addition of $1,500 annual maximum for preventative and comprehensive dental at no additional cost.
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