Coverage,Value Partnerships,Collaborative Quality Initiatives,Patient-Centered Medical Home,Affordability
Blue Cross Value Partnerships Program Prevents $6.3 billion in Health Care Expenses in Michigan Over 20 Years
Lindsay Knake
| 4 min read
Lindsay Knake is a brand journalist for Blue Cross Blue Shield of Michigan.
Twenty years ago, Blue Cross Blue Shield of Michigan and a small group of physician leaders gathered to devise a way to slow the exponential rise in health care costs, while improving health care quality and outcomes for patients. Together, we determined how to focus our efforts, and committed to collaboration.
We created new payment models that compensated providers for higher quality and better outcomes and offered support to build capabilities for additional care services. We called these efforts Value Partnerships. It was innovative then and continues to be a national model of effective partnership between a health plan and health providers.
Now, 20 years of Value Partnerships initiatives has led to lifesaving and life-changing care across the state, along with substantially preventing $6.3 billion in health care costs.
This is because the initiatives within the Value Partnerships portfolio of programs have propelled physicians and their care teams statewide to coordinate patient care and avoid repeated tests, reduce complications and errors, and prevent emergency room visits and hospital stays. All of this prevents unnecessary health expenses.
Collaboration - The Key to Success
“Michigan is leading the way nationally, due largely to the Blue Cross Value Partnerships program, bringing together stakeholders from around the state to improve population health outcomes. Through program participation, we have expanded clinical resources, integrated behavioral health in primary care offices and anchored the partnership between our primary care physicians and their patients,” said Jenifer Hughes, president of Administrative Network and executive director of Oakland Southfield Physicians.
Value Partnerships started with a just a few programs focused on quality improvement in the primary care and surgical settings. Today, there are a significant number of initiatives promoting safety, quality, population health, patient engagement and coordination of care. These initiatives exist across hospital, skilled nursing facility and outpatient settings. Along with the number of initiatives, the number of participants has steadily grown, now encompassing 20,000 physicians, 40 physician organizations and more than 100 hospitals across Michigan. Value Partnerships greatly influences health care quality, outcomes and costs provided throughout the state.
Improved Quality, Successful Outcomes
Through collaboration within Value Partnerships initiatives, physicians and other providers have reshaped the way care is delivered, resulting in widespread change in care processes that improve the health care experience.
For example, surgeons developed new guidelines for opioid prescriptions to minimize the use of these drugs after surgeries. This helps patients recover more quickly, reduces risk of opioid addiction and reduces long-term cost.
"When the programs bring together clinicians in a field with patients to work collaboratively to improve healthcare, something simply magical happens. As program director of the Obstetrics Initiative, I am inspired every day by the work our community is doing to make birth better for everyone and can't wait to see what we'll achieve in the next 20 years!” said Michelle Moniz, M.D., MSc, program director of Obstetrics Initiative.
Another example is the Collaborative Care program, where health care providers have integrated mental health services into primary care practices. Patients have greater access to behavioral health specialists and faster interventions in more than 275 practices across Michigan.
Many of the Value Partnerships initiatives emphasize preventive care rather than treating people once they are sick.
“Twenty years ago, the traditional healthcare reimbursement paradigm preferentially supported reactionary sick visits. As a result, individual providers were left frantically trying to meet the needs of an increasingly complex patient population,” said Kurt Lindberg, MD, family physician and president and medical director at Holland PHO. “Through the Value Partnerships program, our offices employed care managers and mental health providers, surrounding our patients with a diverse team of caregivers to keep them healthy and reduce expensive rescue care. The shift to value-based reimbursement has prevented an estimated $6.3 billion in health expenses and should embolden our efforts to continue working together to provide more efficient, higher quality health care.”
The Value Partnerships collection of clinical quality improvement programs among Blue Cross, physicians and hospitals across Michigan make health care work better for everyone. Learn more about Blue Cross’s Value Partnerships.
Image: Getty Images
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