Michigan Blues shares claims data to help improve quality, lower costs

Blue Cross Blue Shield of Michigan (BCBSM) recently launched a new initiative to help hospitals better understand their utilization patterns so they can know which practices result in the best outcomes and lowest costs.

Under the Michigan Value Collaborative (MVC), which Blue Cross started last month, the insurer and the University of Michigan Health System will use claims data to determine cost and utilization patterns among 130 hospitals throughout the state. They will focus on 10 conditions, including congestive heart failure, and 10 surgeries, such as hip replacement, that frequently have wide cost variations, AIS Health reported.

One problem right now is there's almost a $20,000 difference among cardiac bypass surgery costs for 27 Michigan hospitals. So with the MVC, "hopefully you'll see a narrower range of variation in cost ... with improved outcomes," says BCBSM Senior Vice President of Value Partnership David Share, M.D.

Blue Cross will give hospitals real-time access to information on a dedicated website so they can "drill down their own experience in 20 areas in a real dynamic way," Share told AIS Health. The MVC program also will hold meetings three or four times a year with clinical and financial leaders to share results and improvement strategies.

But launching MVC wasn't easy and took several years of development. One of the biggest challenges has been analyzing and sharing data with many hospitals "in an easy-access electronic format," Share added.

BCBSM has been investing in several payment reform initiatives, including a medical home project that saved $155 million and boosted quality and a value-based reimbursement model with one hospital to reduce premiums while coordinating care, FierceHealthPayer previously reported.

To learn more:
- read the AIS Health article

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