Blue Cross Quality Efforts Save $600M in Health Care Costs


Five programs sponsored by Blue Cross Blue Shield of Michigan and Blue Care Network — designed to improve the quality of certain medical and surgical procedures — have produced nearly $600 million in health care cost savings, according to the results of a recent analysis, Blue Cross officials announced today.

The examination found the program savings — achieved through widespread collaboration between the insurer and 75 Michigan hospitals — resulted from avoided costs, specifically complication reductions and prevention of erroneous and unnecessary procedures.

“These initiatives are rapidly improving the health care environment across the state, and have positioned Michigan as a national leader in transforming health care through collaboration among hospitals, physicians, health professionals, and insurers,” says Daniel J. Loepp, president and CEO of Blue Cross Blue Shield of Michigan. “This model enables competitors to work together as partners in large-scale efforts that reduce complications, improve patient outcomes, and significantly decrease unnecessary health care costs.”

From 2008 to 2012, the Michigan Surgical Quality Collaborative, focused on general surgery, resulted in $230.3 million in statewide savings and $106.2 million in insurance savings. During that same time period, the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative, focused on cardiac and thoracic surgery, resulted in $78.2 million in statewide savings and $5.7 million in savings to the Blues.

What’s more, the initiatives — which also cover bariatric surgery, angioplasty, vascular conditions, and cardiac surgery — have lowered complication and mortality rates for thousands of patients.

“While the dollar savings are important, it’s crucial to see the meaning behind the money,” says David Share, senior vice president of value partnerships at Blue Cross Blue Shield. “These (Collaborative Quality Initiatives) are saving and improving lives. The cost savings come because people are coming home from the hospital sooner, and healing without complications so they can return to work on time.”

In total, there are 15 hospital-based CQIs for which participating physicians and health professionals review data and share experiences to develop best practices and new processes that reduce errors, prevent complications, and improve patient outcomes.

In addition to the five CQIs noted for cost savings, the 10 other CQIs focus on blood clot prevention, blood clot management, breast cancer, trauma center quality, operating room safety, hip and knee replacement, spine surgery, anesthesia, surgical episodes of care, and radiation treatment for cancer.

“There are no other quality improvement initiatives structured like these Collaborative Quality Initiatives, and the unique structure works,” says Dr. Jack Billi of the University of Michigan Health System, which serves as the coordinating center for most of the initiatives. “Because there’s a strong environment of cooperation among these statewide consortiums, and because participants are encouraged to work with their colleagues on issues they deem important, participants are highly engaged and able to make fast progress.”