It is a collection of programs among Blue Cross, physicians and hospitals across Michigan that make health care work better for everyone.
It is a unique, collaborative model that enables robust data collection and fosters the sharing of best practices, so health professionals can improve patient outcomes.
It is value-based, outcomes-based health care.
It is a movement away from the fee-for-service model that pays providers for every service regardless of its effectiveness. Value Partnerships initiatives pay health care providers for successfully managing their patients’ health.
These results moderate health costs – saving nearly $2.2 billion over the last decade because repeated tests were avoided, complications and errors were reduced, ER visits and hospital stays were prevented, and care was coordinated.
Value Partnerships began in 2005 with a handful of programs focused on quality improvement in the primary care and surgical arena Today, there are 10 major programs that house roughly 50 initiatives encouraging safety, quality, population health and coordination of care. Learn more about the programs below and see our latest fast facts sheet here.
Physician Group Incentive Program
Launched in 2005, the Physician Group Incentive Program includes over 20,000 primary care and specialist physicians throughout Michigan in provider-led clinical quality improvement efforts. The program connects approximately 40 physician organizations (representing these 20,000 physicians) statewide to collect data, share best practices and collaborate on initiatives that improve the health care system in Michigan. Participating […]
Since 2009, Blue Cross Blue Shield of Michigan’s Patient-Centered Medical Home designation program has fueled statewide movement of primary care into a team-based, proactive model of efficient, cost-effective care centered around the patient. No other health plan-led PCMH designation program has the size or results of the Blue Cross PCMH designation program. PCMH-designated providers are […]
Provider-Delivered Care Management
PCMH-designated practices provide personalized care management services for patients with chronic conditions or multiple, ongoing health needs. Patient care teams are assembled according to each patient’s needs, and may include nurses, nutritionists, counselors, psychologists, respiratory therapists, asthma educators, certified diabetes educators, social workers, pharmacists and community health workers. Services are coordinated with the care patients […]
The Health Information Exchange Initiative supports physicians and physician organizations who participate in statewide data sharing through the Michigan Health Information Network Shared Services (MiHIN). Participants receive daily emergency room and inpatient admission, discharge, transfer alerts and medication information for their entire patient population. This enables physicians to follow up with their patients sooner, better […]
Performance Recognition Program
This program enables primary care physicians serving patients with Blue Care Network, BCN Advantage and Medicare Plus Blue PPO plans to earn value-based reimbursement for meeting quality performance measures. Measures are outlined by the National Committee for Quality Assurance in their Healthcare Effectiveness Data and Information Set® (HEDIS). Measures are focused on preventive care and […]
The Blueprint for Affordability program combines quality and care coordination with a risk-based contract that enables providers to manage the health of their patient population and lower their total cost of care. Physician organizations and health systems work with Blue Cross to identify how much care should cost for their patient populations, and then work […]
Collaborative Quality Initiatives
Collaborative Quality Initiatives address many of the most common and costly areas of surgical and medical care in Michigan. In each CQI, hospitals and physicians across the state collect, share and analyze data on patient risk factors, processes of care and outcomes of care, then design and implement changes to improve patient care. It’s working. […]
Through Pay-for-Performance programs and Value-based Contracting, hospitals earn reimbursement for improving quality, cost efficiency and population health. Pay for Performance Hospitals earn reimbursement for improving quality, cost efficiency and population health. This program recognizes both mid-to-large and small rural short-term acute care hospitals through a focus on patient safety as well as quality improvements. Measures […]