Blue Cross Blue Shield of Michigan in Detroit has launched the state’s first value-based health plan. The program offers small and mid-sized businesses lower health care costs by providing members with access to a network of coordinated care professionals and services.
The health plan, called Personal Choice PPO, gives members access to 38 Organized Systems of Care in Michigan, which are communities of doctors and hospitals that collaborate to provide customized patient care. Plan members can choose from more than 4,300 primary care doctors, 11,630 specialists, and 118 hospitals.
David Share, senior vice president of value partnerships at Blue Cross Blue Shield of Michigan, says the plan’s cost savings are a result of encouraging members to engage in their health care, with options to choose medical services within an Organized Systems of Care to save on out-of-pocket costs.
“It’s a system where the stronger performance of the provider works to deliver greater value to the patient, and ultimately lower cost to those patients’ employers,” he says.
The Personal Choice PPO plan divides the Organized Systems of Care into two levels, which Share says ensures quality of care and lower costs.
By selecting primary care doctors and providers in Level One, members have lower copays and deductibles. Opting for health care outside Level One provides coordinated care at a higher cost to the member.
“More than 90 percent of Blue Cross members have employer-based health insurance,” says John Dunn, vice president for middle and small group business at Blue Cross Blue Shield of Michigan. “We’re taking the PPO to the next level with this product. We believe employers who have been seeking HMO options for affordability reasons are going to be pleasantly surprised with how affordable Personal Choice PPO is by comparison.”