Partnerships among physicians, hospitals and Blue Cross Blue Shield of Michigan (BCBSM) are saving lives, improving patient care and reducing costs in a newly published partnerships report from the Blues.

"These partnerships demonstrate the powerful, positive impact created by hospitals, physicians and the Blues to truly transform healthcare in Michigan," said Daniel J. Loepp, Blues president and CEO.

Titled "Partners in Healthcare: 2008 Partnerships Update," the report highlights several areas of partnerships such as Value Partnerships – innovative collaborations among physicians, hospitals and the Blues to improve healthcare quality, value and efficiency; work under way through the Michigan Health & Hospital Association (MHA) Keystone Center; activities supporting free healthcare clinics in the state; and technology partnerships aimed at making administrative functions more efficient.

Several partnership initiatives have earned acclaim – most recently from the National Business Coalition on Health – for providing a healthcare industry model for partnerships with up-front feedback and collaboration from physicians, nurses and hospitals.

"The partnership model in place enables participating hospitals, physician groups and other healthcare professionals to work together to achieve better, more affordable healthcare," said Dr. Thomas Simmer, BCBSM senior vice president and chief medical officer. "We know many health plans have pay-for-performance programs. But we don’t know any that has instituted a model where doctors and hospitals drive the design and execution of programs with the scope and statewide impact as the programs operating in the state of Michigan."

The report cites a Value Partnership initiative that has improved care for patients undergoing angioplasty. The initiative, known as the BCBSM Cardiovascular Consortium, has reduced hospital deaths by 27 percent and heart attacks by 19 percent, with savings estimated at $8 million annually statewide.

The initiative inspired the creation of additional similar partnership programs to improve care in general/vascular surgery, bariatric surgery, cardiac surgery and breast cancer treatment.

The MHA Keystone Center is another example of cooperation between the Blues and hospitals to improve care for state residents. In 2006, BCBSM and the MHA announced an agreement for the Bluesto fund new quality and safety initiatives for hospitals to be coordinated by the MHA Keystone Center. Work by hospitals across the state is under way for a MHA Keystone initiative aimed at reducing healthcare-acquired infections.

The report also looks at the Blues’ Physician Group Incentive Program, another Value Partnerships initiative to improve quality and efficiency and eliminate unnecessary healthcare costs. The program encourages improvements in healthcare delivery, such as coordinated disease management programs for patients, and also produced $7 million in savings by instituting a cost-effective prescribing program.

The report also spotlights the shared goal of the Blues and physicians throughout the state to improve access to healthcare through the support of activities such as free clinics at Detroit’s St. Frances Cabrini Clinic. The clinic receives funding through Blues’ grant programs.

Cabrini is one of 32 free clinics statewide that received a Blues grant in 2007 as part of the company’s social mission to improve access to healthcare. Since 2005, the Blues have provided $3 million in support of Michigan’s free clinics.

Another area of partnership involves technology. The Blues have created new tools to help physician offices track and process medical claims and are working with physician offices who have become early adopters of the technology.

Address: Blue Cross Blue Shield of Michigan, 600 E. Lafayette Blvd., Detroit, MI 48226; (313) 225-9000, www.bcbsm.com.

Free Trial Subscription

Become a Subscriber

"Managed Care Weekly Watch"
Subscribe Here