Great Lakes Wire

Blue Cross Blue Shield of Michigan is taking steps to manage health care costs while improving the quality of care for its members. The organization's Value Partnerships initiative brings together various efforts to enhance patient safety, clinical quality, and care processes within the state.

Since the beginning of these initiatives in 2005, Value Partnerships has reportedly helped prevent around $6.3 billion in health care costs. While this does not necessarily translate directly to lower out-of-pocket costs for members each year, these efforts are helping slow the rate of rising costs, which Blue Cross refers to as "bending the benefit cost trend."

A key aspect of the strategy is to help members maintain their health, thus reducing the need for medical care. This includes launching various programs focused on both mental and physical well-being, such as the "A Healthier Michigan" blog, and the Blue Cross Virtual Well-Being Program.

Additionally, Blue Cross educates members on selecting appropriate care settings. The high costs associated with emergency room visits are highlighted, and alternatives such as primary care doctors, retail clinics, urgent care centers, and a 24-hour nurse line are recommended for many situations.

The organization also incentivizes health care providers by rewarding them for positive patient outcomes rather than merely performing services. This approach is intended to help maintain member health and reduce unnecessary services.

To keep prescription drug costs in check, Blue Cross uses analytics, reports, clinical reviews, and other methods. They also employ drug utilization management programs to ensure the appropriateness of medications and promote lower-cost treatment alternatives.

Comprehensive care management programs are in place for members with complex health conditions, aimed at improving care and reducing associated costs. The Patient-Centered Medical Home program helps members obtain better care, stay healthier, and reduce emergency room visits.

Furthermore, the Blue Distinction Specialty Care program identifies value-based programs nationwide, with participating providers excelling in key health care metrics.

Blue Cross offers telehealth services through Virtual Care by Teladoc Health℠, providing virtual consultations with certified health professionals, and the Blue Cross Coordinated Care℠ program offers personalized solutions for enhanced customer service and care management.

While many of these programs are available to all members, Blue Cross advises members to verify their benefits to determine eligibility.

Learn more about available small group insurance through the Small Business Association of Michigan (SBAM).

Courtesy of Blue Cross Blue Shield of Michigan.