Blue Cross Blue Shield of Michigan adds 7 providers to value-based care model

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Blue Cross Blue Shield of Michigan now has 14 participants in its Blueprint for Affordability program. Here's what that model entails. (Getty/benkrut)

Blue Cross Blue Shield of Michigan has added seven more providers to its Blueprint for Affordability value-based care program, taking the initiative statewide. 

Blue Cross unveiled the program in December, and the first seven health systems to sign on were largely clustered in the southeastern part of the state. Initial participants included Henry Ford Health System, Ascension Michigan and Michigan Medicine. 

The new crop of providers to join the program—Affinia Health Network, Genesys PHO, Great Lakes OSC, Holland Physician Hospital Organization, Munson Healthcare Clinically Integrated Network, Northern Physicians Organization and Mary’s PHO—extends the model’s reach to the rest of the state. 

“The power and value in Blueprint for Affordability comes from everyone joining together to challenge the status quo,” Blue Cross CEO Daniel Loepp said in a statement. “Now throughout the lower peninsula, people will benefit from higher quality healthcare at costs they can better manage.” 

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Under the model, participating providers sign on to work toward annual targets for the cost of care provided to Blue Cross members. Those who come in under the targets will earn financial rewards, while those that exceed them must reimburse Blue Cross part of the excess spending. 

The program harnesses analytics to ensure participants are equipped to manage their patients more efficiently. The model is designed to avoid unnecessary hospitalizations, tests, scans and emergency department visits. 

Blue Cross said in December that the initial group of providers represented about 30% of its membership in commercial PPO and Medicare Advantage PPO plans and accounted for about $4 billion in healthcare spending. 

“Thanks to the leadership, knowledge and tenacity of these health plans and physician organizations, costs will become more predictable for Blue Cross customers and the quality and efficiency of healthcare will improve for patients across the state,” Loepp said. 

The model iterates on existing value programs Blue Cross operates. The insurer said that it has over 50 value-based partnerships in place that have saved $2.2 billion since 2016.