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Partnerships Report Highlights How Blue Cross Blue Shield of Michigan, Physicians and Hospitals Are Working to Save Lives, Improve Care, Reduce Costs

Value Partnerships, MHA Keystone and other initiatives are featured

DETROIT, March 12 /PRNewswire/ -- Physicians and other health care professionals provide an inside look at how groundbreaking partnerships among physicians, hospitals and Blue Cross Blue Shield of Michigan 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 health care in Michigan," said Daniel J. Loepp, Blues president and CEO. "We thank all of our participating hospitals, physicians and other health care partners for joining us on this important journey."

Titled "Partners in Health Care: 2008 Partnerships Update," the report highlights several areas of partnerships: Value Partnerships -- innovative collaborations among physicians, hospitals and the Blues to improve health care quality, value and efficiency; work under way through the Michigan Health & Hospital Association Keystone Center; activities supporting free health care 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 health care 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 health care professionals to work together to achieve better, more affordable health care," said Thomas Simmer, M.D., 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 Partnerships 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.

"Our results show just what can be achieved when hospitals cooperate, rather than compete, in a joint effort aimed at improving care," said Mauro Moscucci, M.D., University of Michigan Health System cardiologist and BCBSM Cardiovascular Consortium director.

The Michigan Health & Hospital Association 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 Blues to 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 health care-acquired infections.

"Michigan hospitals have successfully pursued evidence-based approaches to further prevent infections," said Spencer Johnson, MHA president. "MHA Keystone Center has a proud tradition of bringing clinical experts together and uses rigorous measurements to assure effective change."

"This initiative is first of several that we intend to undertake as part of this partnership with MHA Keystone to look at areas where improvement can have a positive impact on the greatest number of patients," said Robert Milewski, Blues senior vice president for contracting and hospital relations.

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

"With the complexity of today's health care system, it's important for everyone to pull together to improve health care, access to quality health care and cost-effectiveness," said Paul Ponstein, D.O., medical director of Westshore Health Network in West Michigan and an original PGIP member whose commentary on the program is included in the report.

"By bringing together physicians from across the state, we're able to network, problem-solve and share best practices," said Kevin Taylor, M.D., medical director of Ann Arbor-based Huron Valley Physicians Association and an active PGIP participant.

The report also spotlights the shared goal of the Blues and physicians throughout the state to improve access to health care through the support of activities such as free clinics. It profiles Susan Schooley, M.D., who sees patients as a volunteer at Detroit's St. Frances Cabrini Clinic. The clinic receives funding through Blues' grant programs.

Schooley explains, "What makes this special is the almost painful awareness that if I and the other volunteers weren't doing this, no one would be. We are the safety net below the safety net below the safety net."

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 health care. 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.

"Electronic funds transfer, which pays for medical claims through electronic versus paper vouchers, is a new tool introduced by us for physicians' offices. Physicians' offices across the state are working with us to eliminate some of the paper involved in health care claims processing," said Simmer.

The partnership report is being mailed to physician groups and hospital leadership throughout the state. A complete copy of the report is in the provider section of BCBSM's Web site ( ).

Blue Cross Blue Shield of Michigan, a nonprofit organization, provides and administers health benefits to more than 4.6 million members residing in Michigan in addition to members of Michigan-headquartered groups who reside outside the state. The company offers a broad variety of plans including: Traditional Blue Cross Blue Shield; Blue Preferred, Community Blue and Healthy Blue Incentives PPOs; Blue Care Network HMO; BCN Healthy Blue Living; Flexible Blue plans compatible with health savings accounts; Medicare Advantage; Part D Prescription Drug plans, and MyBlue products in the under-age-65 individual market. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. For more company information, visit .

SOURCE Blue Cross Blue Shield of Michigan
Copyright©2008 PR Newswire.
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