RELEASE
Over 20 years, Blue Cross Blue Shield of Michigan’s Value Partnerships program delivers $6.3 billion in prevented medical expenses through better quality and patient outcomes
Teddy Lemmer
| 5 min read
DETROIT, Oct. 10, 2024 – As part of celebrating 20 years of collaborative efforts to transform Michigan’s health care landscape through its Value Partnerships programs, Blue Cross Blue Shield of Michigan announced today that the programs have collectively prevented $6.3 billion in medical expenses. This cost avoidance has lessened the pressure on health insurance premiums for employers and people in Michigan over two decades.
Value Partnerships is a collection of collaborative initiatives among Blue Cross, physicians, physician organizations and hospitals statewide that have led to higher quality care, fewer complications, shortened inpatient hospital stays, more efficient processes and better patient and provider experiences. What began as a handful of initiatives focused on quality improvement in primary care and surgery has grown into a suite of clinical quality and value-based payment programs. The sheer breadth of the Value Partnerships programs greatly impacts health care quality, patient experience, clinical outcomes and costs throughout the state.
The program platform is comprised of 20,000 physicians, 40 physician organizations and more than 100 hospitals.
- Value Partnerships participating physicians are in 79 of Michigan’s 83 counties.
- About 3 million Blue Cross members see a Michigan Patient-Centered Medical Home provider.
- Approximately 73% of Blue Cross primary care physicians participate in the Physician Group Incentive Program, a collection of health care transformation and quality improvement initiatives for primary care physicians and specialists.
- Physicians and hospitals from 26 states are participating in Collaborative Quality Initiatives, each aimed at improving specific medical or surgical procedures and processes.
“Value Partnerships is a renowned national model for value-based health care and a driving force behind pivotal, systemic change in the way health care is delivered,” said Daniel J. Loepp, who has been president and CEO of Blue Cross Blue Shield of Michigan since 2006 and will retire at the end of 2024. “Everyone wants the cost of health care to be more manageable. Health insurance costs would likely be higher in Michigan today if not for the success of these programs in improving quality and patient outcomes. Over the past two decades, Value Partnerships has made Michigan a safer, higher quality place to receive health care, and we couldn’t be prouder of the impact made by this incredible team.”
Collaboration, quality improvement and more efficient processes have led to significant prevention of medical expenses:
- Collaborative Quality Initiatives (CQIs) that improve medical and surgical processes have avoided $4.08 billion in costs by preventing complications and improving outcomes. Today, Blue Cross oversees over 20 CQIs.
- The nation’s largest health plan-led Patient-Centered Medical Home designation program has prevented $813.5 million in ER visits and hospital stays.
- Provider-Delivered Care Management, care management services offered through the primary care practice, has prevented $1.25 billion in medical costs by avoiding emergency room visits, hospital admissions and hospital re-admissions.
- Through 2017, the Hospital Value-Based Payments initiative with statewide contracts has avoided $160 million in medical costs due to more favorable patient care outcomes.
“This large-scale collaboration between Blue Cross and over 20,000 physicians is truly unique in the health care industry, allowing us to drive monumental change at an unmatched pace,” said James Grant, MD, senior vice president and chief medical officer at Blue Cross Blue Shield of Michigan. “The mutual respect and joint efforts of all participants in Value Partnerships have been instrumental to its success. The structure of these programs is based on the recognition of physicians' expertise and a deep appreciation for their intrinsic motivation to take great care of their patients. By independently empowering Michigan physician leaders to help determine each program's construction and measurement, we've created a framework that fosters continuous improvement and innovation.”
“Twenty years ago, the traditional health care 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.”
“Regulatory pressures in organizational strategic priorities inform many improvement efforts, but these often leave out the patients and providers. The Value Partnerships program puts patients and providers front and center, creating a continuous learning environment where best practices are shared and care moves forward,” said Michael Englesbe, MD, FACS, medical director, Collaborative Quality Initiatives andCyrenus G. Darling Sr., MD and Cyrenus G. Darling Jr., MD Professor of Surgery at the University of Michigan. “Healthier patients do better when they get sick, and they get sick less often. Collaborative Quality Initiatives lead the way in these efforts, serving as an internationally recognized model of excellence.”
For more information about Value Partnerships, go to valuepartnerships.com.
Blue Cross Blue Shield of Michigan, a nonprofit mutual insurance company, is an independent licensee of the Blue Cross Blue Shield Association. BCBSM provides health benefits to more than 4.7 million members residing in Michigan in addition to employees of Michigan-headquartered companies residing 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 more than 80 years. Beyond health care coverage, BCBSM supports impactful community initiatives and provides leadership in improving health care. For more information, visit bcbsm.com and MiBlueDaily.com.
Header photo featuring BCBSM leaders from left to right:
Jason Hover, vice president care delivery, transformation and affordability; Sue Burns, senior director, provider network contracting, management and support; Dr. Jim Grant, senior vice president and chief medical officer; Sue Barkell, senior vice president, provider contracting and network operations; Dr. Amy Milewski, vice president of clinical partnerships and associate chief medical officer; and Todd Van Tol, executive vice president, Health Care Value.
