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The Risks and Benefits of Radiology Exams

Posted on May 7, 2013 by DReinheimer

If you’ve received an X-ray for a foot injury, or had a CT scan to check the cause of repeated headaches, you may wonder if the radiation given off by these tests is harmful to you.  Some types of imaging tests, such as ultrasound and MRI exams, do not expose you to damaging radiation. Other tests, such as X-rays, CT (or CAT) scans and nuclear scans, do expose you to ionizing radiation.  Although the risk of getting cancer from this radiation is extremely low, you still want to have these tests only when they are medically necessary.

As part of the radiology management initiative within the Physician Group Incentive Program, we are working to promote awareness of radiation exposure and appropriate imaging.  Leading organizations, such as the American College of Radiology, create guidelines to help physicians decide when and when not to perform radiology exams.  Doctors weigh the benefits and the risks when they are ordering these tests for their patients.

Radiation exposure amounts vary by the type of exam and the body part being scanned.  Exposure can even be different for the same test done on different machines. 

Helpful sites with additional information include http://radiologyinfo.org/  for patients and imagewisely.org for health care professionals.

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How Organized Systems of Care Improves Care Delivery

Posted on April 26, 2013 by DReinheimer

Blue Cross Blue Shield of Michigan and close to 40 physician organizations throughout the state are working together to determine the most effective structure and processes to improve care delivery, and to measure the outcomes of that care. One such structure is called an Organized System of Care, or OSC.

An OSC is based on Patient-Centered Medical Home principles, where doctor-led teams work together to care for each patient. But an OSC takes it further, creating a community of health professionals all working together to care for a group of patients across all locations.

Why does this improve care?

  • Technology – Doctors and health professionals use patient registries to better understand the needs of their patients and make sure patients are receiving the services they need, such as mammograms, diabetes tests, and immunizations.; portals to provide patients with easy access to their doctor’s office; and electronic prescribing to help ensure prescription safety  
  • Provider collaboration – Doctors and health professionals are developing their ability to make sure all are working together to coordinate patient care and close gaps.
  • Care management – patients with a chronic disease may have a care manager – in addition to their doctor – who will help manage their condition and ensure they get the right care at the right time.
  • Extended office hours –doctors may have evening or weekend hours for appointments and 24-hour telephone access.
  • Performance measures – Doctors and health professionals develop ways to measure their performance so they know what they’re doing well and what needs improvement.
  • Finally, doctors and health professionals work within PCMH-designated offices and systems of care making it easier to collaborate and communicate to make sure patients are receiving all needed health care services, whether the care is in the doctor’s office, outpatient facility, hospital or some other location for care.

For more information, go to the Organized Systems of Care tab.

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Dr. “Skip” Campbell cited as nationwide leader in patient safety

Posted on April 8, 2013 by admin

Darrell A. “Skip” Campbell Jr., a top surgeon at the University of Michigan who leads the Michigan Surgical Quality Collaborative, has been named one of the nation’s top 50 experts leading the field of patient safety.

Becker’s Hospital Review, a monthly publication focusing on legal and business issues for hospital executives, named Campbell Jr. as one of “50 Experts Leading the Field of Patient Safety” in its April edition.

Campbell Jr. is chief of clinical affairs and chief medical officer at the U-M Health System and Henry King Ransom Professor of Surgery in the Department of Surgery. He was recognized in part for his work leading the Michigan Surgical Quality Collaborative, a joint effort between 52 hospitals to reduce complications and surgical site infections by sharing data and identifying best practices.

The initiative, one of 12 hospital partnership funded by BCBSM, saved an estimated $85.9 million in health care costs over two years while improving patient outcomes on a host of fronts.

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Project Aims To Help Cancer Patients Stop Smoking, To Improve Treatment Outcomes

Posted on March 12, 2013 by DReinheimer

Evidence suggests that smoking may make cancer treatment less effective, and may make cancer patients less tolerant of the treatment.  Smoking may increase a cancer patient’s risk of complications from treatment, and increase the risk for a secondary cancer.

Some health care professionals think that asking a cancer patient to stop smoking causes them too much stress, or that it’s too late to be helpful.  Yet, stopping tobacco use immediately after being diagnosed with cancer gives patients the best chance for their cancer treatment to work.

This month, a group of oncologists and other health care professionals are launching a demonstration project that aims to identify every cancer patient who uses tobacco, advise them to quit, and refer them to resources to help them quit.  The group, the Michigan Oncology Quality Consortium, will partner with the Michigan Cancer Consortium, to create a process within an oncologist’s practice that will automatically refer cancer patients who smoke to the Michigan Tobacco Quitline (1-800-QUIT-NOW), or other cessation services.

“This is a great opportunity for oncology doctors and care teams to make sure their patients receive the necessary professional counseling and support for quitting tobacco use before they begin chemotherapy or surgery,” says Jane Severson, the consortium’s project manager

For additional information about this project contact Jane Severson, Michigan Oncology Quality Consortium, at JSeversn@umich.edu. For more information about the consortium, please visit www.moqc.org

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How are we transforming health care?

Posted on January 31, 2013 by DReinheimer

Launched in 2012, three new Collaborative Quality Initiatives (CQI) are among the latest Value Partnerships program aimed at improving health care value.

The three CQIs are introduced in the fifth annual Partners in Health Care Report: Transforming Health Care.

“Since 2005, the Blues have partnered with tens of thousands of physicians across the state – and nearly every hospital – through the groundbreaking Value Partnerships program. It’s a program that’s transforming health care in the state, improving quality and outcomes and bringing greater health care value to Michigan,” President and CEO Daniel J. Loepp said in the report’s introduction.

Following are examples of how Collaborative Quality Initiatives are making a difference:

  • The 33 hospitals on the BMC2 angioplasty CQI reported a 20-percent decrease in hospital deaths.
  • The Advanced Cardiovascular Imaging Consortiumreduced radiation doses by more than 60 percent.
  • The Michigan Surgical Quality Collaborative reported a 15-percent reduction in length of stay for hospital patients.
  • Four of the longest-running CQIs saved more than $232 million statewide over three years. BCBSM savings were over $70 million during this time period.
Three new CQIs launched in 2012

  • Michigan Arthroplasty Registry for Collaborative Quality Improvement, which aims to improve the quality of care for patients undergoing hip and knee joint replacement surgery.
  • Michigan Radiation Oncology Quality Consortium, which aims to determine which breast and lung cancer patients are most likely to benefit from intensity modulated radiation therapy.
  • Michigan Urological Surgery Improvement Collaborative, which is working with urologists across Michigan to improve health care outcomes for men with newly diagnosed cases of prostate cancer.
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‘Business Imperative’: Value Partnerships collaboration featured in health-business magazine cover story

Posted on January 31, 2013 by DReinheimer

BCBSM President and Chief Executive Daniel J. Loepp is featured on the cover of the January edition of Managed Healthcare Executive magazine for a story about the Blues’ efforts to improve health care quality and contain costs by partnering with doctors and hospitals.

The story, “Business Imperative: Collaborating with  providers has become an essential strategy,” examines  a few of BCBSM’s collaborations in detail. Editor-in-chief Julie Miller writes that “Collaborative models have the  effect of encouraging competing hospitals and practices to set their politics aside and focus on learning best practices
from each other.” They also help encourage transparency as health care providers focus on learning from one another, the story continues:

However, as the healthcare landscape changes under the Patient Protection and Affordable Care Act (PPACA), Loepp believes payers will have to modify their strategies.

“What we’re doing around patient-centered medical homes and our Physician Group Incentive Program may be different in two or three or four years,” he says. “It may take a different turn; I’m not sure what, honestly, because there are a lot of unknowns with the Affordable Care Act. But, I can’t see any situation where the collaborative model isn’t going to be at the forefront.”

Managed Healthcare Executive is a monthly business-to-business publication that relies on a 14-member editorial advisory board of managed care professionals. The magazine is based in North Olmsted, Ohio.

For more, read the digital edition of the January issue.

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Orientation for new physician organizations helps PGIP program grow stronger

Posted on November 27, 2012 by admin

On a hazy Thursday morning, more than 100 people from all over Michigan – including Marquette – gathered at the BCBSM conference center in Lyon Township for a 2-day deep dive into the award-winning Physician Group Incentive Program.

Two full days, one huge handbook and lots of conference carbs and candy later, attendees came away with more knowledge and commitment to participating in a series of initiatives that improve care quality and efficiency.  The data collection and reporting required to participate in these initiatives can be complicated.  But participants know it’s worth their time, because they know this is the way to change health care delivery.

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Health Affairs article shows ‘fee for value’ model effective

Posted on November 8, 2012 by admin

You haven’t been feeling well, so you finally decide to call your primary care doctor.  That doctor runs a battery of tests, then refers you to a specialist to get specific treatment.

“Great,” you’re thinking.  “They’re going to run the same tests and I am going to have to pay again.”

When you sit down with the specialist, you are pleasantly surprised because the doctor has the results of your last tests.  There is no need to run them again in order to confirm a diagnosis and recommend a treatment plan.

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Quality improvement projects in Michigan helping bend the health care cost curve

Posted on August 1, 2012 by admin

If you are concerned about what’s going on with the escalating cost of health care in this country, you should feel good about the work going on right here in Michigan.

Four programs BCBSM sponsors with Michigan hospitals have saved a combined $232.8 million over three years, lowering complication rates for Michigan patients and literally saving lives.

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BCBSM Chief Executive Daniel J. Loepp

Daniel J. Loepp op-ed in The Detroit News celebrates success of Michigan hospital partnership

Posted on August 1, 2012 by admin

Initiatives under way across Michigan that benefit from Blue Cross’ support are receiving national recognition for their success in slowing health care costs, BCBSM President and Chief Executive Daniel J. Loepp writes in a recent Detroit News opinion piece.

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