BCBSM Announces New ‘Blueprint for Affordability’

December 12, 2019 — Blue Cross Blue Shield of Michigan (BCBSM) announced on December 11 that it has reached new 5-year value-based, performance-based, risk-based payment contracts with seven hospital systems and physician groups in southeast Michigan:

  • Ascension Michigan (GenesysPHO, Partners in Care, St. Mary’s PHO)
  • Henry Ford Health System, Detroit
  • Michigan Medicine
  • Oakland Southfield Physicians
  • The Physicians Alliance
  • Trinity Health-Michigan (Saint Joseph Mercy Health System, Mercy Health, Mercy Health Physician partners, IHA)
  • United Physicians

Beginning January 1, ‘Blueprint for Affordability’ participants must meet agreed-upon annual cost targets or pay penalties. BCBSM has added additional medical directors and other staff to support contracted providers in these efforts aimed at containing healthcare costs by increasing quality of care; avoiding unnecessary tests, scans, and emergency room visits; reducing complications and rehospitalizations; and improving care coordination. Ultimately, BCBSM said, savings may be passed along to customers in the form of lower premiums, a slower growth in the cost of premiums, or enhanced benefits.

‘Blueprint for Affordability’ will affect BCBSM’s Commercial PPO and Medicare Advantage PPO members, which represent 30% of the covered population in southeast Michigan. Additional systems and providers in the southeast region are expected to be added to the payment model in 2020, with a rollout in other parts of the state to begin later in the year.