Blue Cross Blue Shield of Michigan’s Value Partnerships program has transformed the state’s health care landscape, saved $1.4 billion

Over the last 10 years, Blue Cross Blue Shield of Michigan, together with hospitals, physicians and care providers across the state, have collaboratively improved clinical quality, efficiency and health outcomes, saved lives and directly prevented $1.4 billion in health expenses.

These successes come from the Blue Cross Value Partnerships suite of clinical quality initiatives and value-based payment programs, which include more than 19,000 physicians and 75 hospitals in Michigan that participate and collaborate to improve care processes and outcomes. 

“We are a national leader in advancing health care quality and developing a high-performing, value-based, cost-effective health care system,” said Daniel J. Loepp, BCBSM president and CEO. “And we have achieved success through collaboration, which isn’t easy. Value Partnerships has improved care and value, both for our customers and others.”

Value Partnerships efforts have directly saved $1.4 billion in health care expenses by achieving safer, higher quality care and reduced complications. It’s the unique collaborative model that catalyzes such progressive change. Because physicians and care providers statewide are working together to share and implement best practices, quality and safety improvements occur quicker and on a larger scale than similar initiatives that involve only one site or group. 

“These initiatives are improving and saving lives through prevented complications, higher quality of care, improved outcomes and improved processes of care,” said David Share, MD, MPH, BCBSM senior vice president of Value Partnerships. “Together with our provider partners, we are moving from a fee-for-service to a value-based payment model.  Michigan is a safer, higher quality state for health care as a result.”

Nearly two million BCBSM members are cared for by providers who participate in the Value Partnerships programs.  However, the cost savings and care improvements benefit all patients.  Value Partnerships participants have changed their processes, so that all patients receive the benefit of these improved care models, regardless of their insurance type, or whether they have insurance. All Value Partnerships programs are based on cooperation, collaboration and information sharing among health professionals.

“The pace, breadth and depth of the progress achieved through the Value Partnerships model of collaboration has elicited interest from many national organizations, insurers and health care companies,” says Dr. Share.  “In fact, we’ve worked with several other Blues plans to help them institute similar programs.  And the Michigan academic community has secured several million dollars in research funding so that others can study and learn from our model and resulting outcomes.”

The University of Michigan Health System has collaborated with Blue Cross to serve as the clinical coordination center for nearly all of the Collaborative Quality Initiatives within the Value Partnerships portfolio. U-M Medical School faculty physicians lead most of the CQIs. Each CQI focuses on a specific type of care, from trauma care to prostate cancer to minimally invasive heart procedures.

“These initiatives work because they are structured in a way that encourages cooperation and learning among practitioners statewide,” said Jack Billi, M.D., U-M associate vice president for Medical Affairs and professor in the Medical School and School of Public Health. “Each hospital and physician group collects its own data. The coordinating center assists in analysis so the physicians can identify problems and propose countermeasures to improve performance. This has improved health care process and practice statewide. It has also served as a valuable source of knowledge to be shared with the global health care community via research publications based on these data.”

Ten years ago, leaders from the Michigan State Medical Society provided input and guidance as the Value Partnerships program was being developed. “Improving patient outcomes while maintaining physician decisions have been foundational to the success of the program. Blue Cross and Michigan physicians are leading the nation in health care reform,” says Rose M. Ramirez, MD, president, Michigan State Medical Society.

The Value Partnerships team also works closely with the Michigan Health and Hospital Association. “Through the Hospital Collaborative Quality Initiatives, 75 Michigan hospitals are working together to measure and improve care in Michigan. As a result of efforts like these, our state’s hospitals and health systems are internationally recognized for being cutting edge and providing the highest quality, safest care,” says Brian Peters, CEO, Michigan Health and Hospital Association.                                                

The Value Partnerships portfolio of initiatives include the nation’s largest Patient-Centered Medical Home designation program, with more than 4,345 physicians designated in 78 of 83 Michigan counties.  Additional initiatives include:

• Collaborative Quality Initiatives – 22 initiatives, each aimed at improving specific medical or surgical procedures and processes.
• Physician Group Incentive Program – Care process and quality improvement initiatives for physician organizations.
• Provider Delivered Care Management – Care management services offered through the primary care practice.
• Organized Systems of Care – A community of providers that coordinate care across all settings for a shared population of patients.
• Hospital Value-Based Payments – Improves individual patient and population-based quality of care and payments based on outcomes.
• National Solutions – Coordinating Michigan’s quality and value programs with similar programs in other Blues plans.

For more information about Value Partnerships, go to valuepartnerships.com.