Affordability
We need a better way
Health care quality and affordability go hand-in-hand. When quality and care coordination improve, wasteful costs can be prevented. We need a better way to improve quality of care, because it keeps health insurance affordable for everyone.
We have a better way
With a focus on better outcomes, Blue Cross, physician groups and health systems have worked together to make Michigan a leader in value-based care. We’ve realized better quality and lower spending through two decades of collaboration with providers statewide on innovative programs that pay for health care that works.
We are working together
We continue to improve health care quality and outcomes through collaborative opportunities that support physicians and serve members and customers. By focusing on value, not volume, we are working together to solve the affordability crisis that impacts us all.
This is our Blueprint for Affordability
Solutions
We’re redefining payment models to improve care and reduce costs.
Blueprint for Affordability balances the financial responsibility for managing the cost and quality of health care. In simple terms, it’s a contract where physicians agree to put a portion of their payment at risk. They can earn that portion – and more – based on how well they manage their patients’ overall health and lower their total cost of care.
When physicians are successful, they receive higher reimbursement. When physicians do not meet care and cost goals, they forego some portion of reimbursement.
But it’s more than that. Blueprint for Affordability is:
- A strategic direction away from volume-focused “fee-for-service” reimbursement, which has proven ineffective in improving patient outcomes and lowering costs.
- A way to give our members the right care, at the right time, in the right setting and personalized to their needs.
- A collection of new tools and partnerships that support physicians and enable their success in new reimbursement models.
Blueprint for Affordability encourages coordination across the many touchpoints where our members receive care. This improves how health care is delivered and helps to:
- Reduce unnecessary ER visits.
- Diagnose and treat conditions before they worsen.
- Avoid repeated and unnecessary testing.
- Reduce complications.
- Prevent repeat trips to the hospital.
- Improve the overall patient experience.
And that improves outcomes and saves money.
Blueprint for Affordability is a long-term strategy to improve health care quality, efficiency and coordination and reduce the cost of care.
It is a better way to reach the health care goals we all share.
Next-Generation Payment Models
Blogs & Videos
Learn more about our efforts to work together to improve care while lowering costs.
Partners
The Facts
Health care spending in the United States is more than $3 trillion per year
*Blue Cross Blue Shield Association
Between 2010 & 2025, prescription drug prices are expected to increase by 136%
*Center for Medicare and Medicaid Services
Treating chronic diseases accounts for 86% of U.S. health care costs.
*Blue Cross Blue Shield Association
90% of the nation’s $3.3 trillion in health care costs are for chronic and mental health conditions.
*Centers for Disease Control and Prevention
75% of health care costs are due to chronic diseases that could be avoided with preventative care.
*Health Payer Intelligence
33% of Americans delayed or avoided necessary (health) care due to cost.
*2016 Commonwealth Fund Survey
