Five Michigan Health Systems Join Blue Cross Model


DETROIT — Five more Michigan health systems have joined Blue Cross Blue Shield of Michigan in new reimbursement model focused on quality and value.

The new reimbursement model calls for hospitals to identify their provider partners in the community and work with them to develop and implement an infrastructure plan that includes an all-patient registry system that allows caregivers at the hospital and in the physician offices to measure an individual’s health performance against similar populations. This approach promotes coordination of care among all providers who treat the same patient which improves care quality, and helps ensure the right care is given at the right time. The hospitals also will work with their physician partners to develop work plans aimed at improving the health of the patient population they serve.

Blue Cross’ model has now been embraced by seven leading Michigan health systems.

“Our new approach to reimbursement puts the patient front and center and represents a new standard for how hospitals are paid,” said Daniel J. Loepp, president and CEO of Blue Cross. “The hospitals joining us today in expanding this model across Michigan are on the leading edge of transforming how health care is provided. Their commitment will benefit thousands of Michigan residents by enabling us to focus on what truly matters – keeping patients healthy while keeping costs down.”

New arrangements were announced between Blue Cross and :

  • Botsford Hospital, located in Farmington Hills.
  • Oakwood Healthcare, which includes its flagship hospital in Dearborn, Oakwood Heritage Hospital in Taylor, Oakwood Annapolis Hospital in Wayne and OakwoodSouthshore Medical Center in Trenton.
  • MidMichigan Health, which includes facilities in Midland, Gladwin, Clare, and Alma.

Expanded arrangements were announced with:

  • Ascension Health Michigan, which includes Borgess Medical Center, Borgess Pipp and Borgess Lee Memorial hospitals near Kalamazoo; Genesys Regional Medical Center in Grand Blanc; St. Mary’s of Michigan in Saginaw; St. Mary’s in Standish; and St. Joseph in Tawas.
  • Beaumont Health System, which includes its hospitals in Royal Oak, Troy, and Grosse Pointe.

Previously, hospital reimbursement placed sole emphasis on the long-standing fee-for-service reimbursement model, which pays hospitals for every service performed. By moving toward value-based reimbursement, Blue Cross rewards the hospitals with a share of the savings achieved when hospitals and physicians coordinate the delivery of efficient and effective care, eliminate re-use and over use of care, and prevent unnecessary re-hospitalizations.

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