Michigan Blues go full steam ahead on health care reform implementation

Many observers were caught by surprise when the U.S. Supreme Court decided to uphold the entire Patient Protection and Affordable Care Act — including the controversial individual mandate requiring all Americans to obtain health insurance.
But at the Michigan Blues, we’re moving full steam ahead with plans to ensure we are compliant and ready for health care reform.
In many ways, we’ve had the shortest distance to travel to become compliant with the law. For example, unlike most insurers, we already guarantee coverage to anyone who needs it and we’ve long practiced community rating which means we do not use health status to determine a premium rate. We also already exceed a new government requirement that says insurers must spend 80 cents of each premium dollar on medical expenses.

These are just some of the ways we were ready for change.  BCBSM also has been preparing vigorously in other areas from the day President Obama signed the law in 2010.

We’ve created a new business unit devoted entirely to preparing our company, customers and stakeholders for the many changes ahead. We’re also advising federal and state policymakers on how to create state insurance exchanges with consistent regulations to best serve consumers.

We’re taking several steps to help Michiganders be prepared for the law, including finding ways to make insurance more affordable for those who aren’t covered, and helping the uninsured understand how subsidies or rules that will expand Medicaid eligibility could help them purchase insurance on the exchange.

Whether you’re an individual consumer, a senior citizen, sales agent, employer or doctor, you can find more information about how health reform affects you at bcbsm.com/healthreform.

Photo credit Envios.

Daniel J. Loepp is president and chief executive officer of Blue Cross Blue Shield of Michigan.

Success of Michigan hospital partnerships lands on New York Times front page

A recent front page story in The New York Times about nationwide efforts to trim hospital costs highlights news coverage of BCBSM’s efforts to improve patient safety and health care quality through its partnerships with Michigan hospitals.

In April, the Blues announced that four of its Collaborative Quality Initiatives with Michigan hospitals saved $232.8 million over three years.

Here’s a roundup of stories that take a deep dive into the news:

New York Times: In Michigan, for example, Blue Cross financed an effort to have the state’s major hospitals compare results in areas like bariatric or general surgery so that they could reduce infection rates and surgical complications. The insurer never sees data that identifies individual hospitals, and the hospitals meet regularly to discuss how they can learn from one another to improve care.

“There’s basically a ‘leave your guns at the door’ attitude,” said Dr. Darrell Campbell, the chief medical officer for the University of Michigan Health System.

The program’s benefits extend far beyond Blue Cross’s own customers, according to the insurer’s calculations. Only a third of the savings was attributable to patients it insured. Unlike previous attempts by insurers to reward individual hospitals for quality and efficiency, the program tries to help all hospitals improve.

The earlier efforts, which focused on overly specific measures or reporting on individual hospitals, “tended to inspire providers to do the least necessary to achieve the incentive rather than the most to transform care,” said Dr. David Share, a senior executive at Blue Cross.

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CHRT Study on Variation in Treatment of Heart Disease in Michigan Yields Coverage in National News Media

A new study from the Center for Healthcare Research & Transformation, a nonprofit partnership between BCBSM and the University of Michigan Health System, that finds wide variation in how providers treat coronary artery disease in different parts of the state has gained attention from the national news media.

The study, Variation in Interventional Cardiac Care in Michigan, focused on treatment methods for stable, non-emergency coronary disease — specifically, the rates of bypass surgery and angioplasty (stents) among patients with BCBSM insurance. It found that while overall rates for the two procedures dropped 19 percent between 1997 and 2008, regional variation rose considerably.

The findings raise concerns about the appropriate use of these high-risk, high-cost procedures in elective, non life-threatening situations when treatments like medication, diet or exercise may be more appropriate.

Here’s a roundup of news coverage:

This is a pretty common story in American medicine right now: A 2008 Congressional Budget Office report estimated that new technologies account for about half of the growth in health care costs. And some do indeed make us healthier: The rise of minimally invasive surgical equipment, for example, has cut the health risks and recovery time for undergoing surgery.

But some may just make healthcare more expensive — without delivering better health outcomes. And that’s not just true for catheterization labs: Another study this year looked at how this happens with prostate cancer treatments. Doctors with access to pricier proton therapies tend to use it more, even though its outcomes have proven no better than less-expensive radiation treatments. (Washington Post)

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Blues on the Radio: Month-Long Spotlight on Revitalizing Michigan Cities in May

In May, The Healthier Michigan Radio Show that airs on radio stations throughout the state will focus on all of the exciting developments happening in Detroit, Lansing and Grand Rapids that are helping to revitalize the state. Program host Ann Thomas will speak with:

  • Dan Loepp, president and chief executive officer of Blue Cross Blue Shield of Michigan, about the investments made by the Blues to help boost Detroit’s economy
  • Bud Denker, senior vice president of Penske Corporation, about the many ways that metro Detroit and Michigan will benefit from the return of the Detroit Grand Prix
  • Tricia Keith, vice president, corporate secretary and services of Blue Cross Blue Shield of Michigan, about why rebuildingDetroit is such an important mission for the Blues and its employees
  • Jeff Connolly, president for West Michigan Operations and Managed Care at Blue Cross Blue Shield of Michigan, about how the Blues support West Michigan through various local partnerships and opportunities

The hour-long show is available online or as a podcast and is scheduled to air at the following times on the following stations:

  • WJR-AM in Detroit – 7-8 p.m. Tuesday, May 1
  • WJIM-AM in Lansing – 7-8 p.m. May 1
  • WOOD-AM in Grand Rapids – 9-10 p.m. Sunday, May 6
  • WTCM-FM in Traverse City – 9-10 p.m. Monday, May 14
  • WATZ-AM in Alpena – 11-11:45 a.m. Wednesday, May 23

WOOD Radio

If you live on Michigan’s west side, listen for Connolly on his regular Tuesday segment with WOOD host Steve Kelly. Connolly will discuss topics including the Blues’ Body & Soul walking challenge. This initiative brings African-American churches together in the area to compete for wellness grants. Other topics include the Collaborative Quality Initiatives (CQI) under way with Michigan hospitals to improve health care quality while lowering costs, and the role of free clinics for the uninsured.

Tigers Radio

Finally, Andrew Hetzel, BCBSM’s vice president of Corporate Communications, joins Dan Dickerson each Sunday throughout the month on the Detroit Tigers Radio Network. This month Hetzel will discuss National Nurses Week, Employee Health & Fitness Month, the Blues’ partnership with Michigan doctors and hospitals to lower health care costs and improve quality, and the Healthy Blue Xtras member program that provides special discounts to Michigan Blue Cross members at retailers throughout the state.

Photo by MeijerGardens

Daniel J. Loepp Op-Ed in Detroit News Celebrates Success of Michigan Hospital Partnerships

Daniel J. Loepp

Initiatives under way across Michigan that benefit from Blue Cross’ support are receiving national recognition for their success in slowing health care costs, BCBSM President and Chief Executive Daniel J. Loepp writes in a recent Detroit News opinion piece.

In the op-ed, “Michigan sets example for saving health care costs,” Loepp discusses how four BCBSM-led Collaborative Quality Initiatives saved $232.8 million by improving clinical quality and patient safety. He also touches on the Blues’ support for the Keystone Center for Patient Safety and Quality, a voluntary program run by the Michigan Health and Hospital Association that has helped improve health care and lower costs.

Loepp writes:

The programs that Blue Cross has under way with doctors involve the voluntary participation of often competing hospitals or physician groups and a willingness to share and compare data around common medical procedures.

This level of collaboration is unprecedented in Michigan health care.

With help from the University of Michigan Health System and Beaumont Hospitals, we’ve been able to determine best-practice protocols for procedures like bariatric surgery, breast cancer treatment and angioplasty.

By having everyone work together, we can determine what’s working and what isn’t, giving huge systemwide boosts to patient safety and clinical quality while lowering costs.

Read the rest of Loepp’s commentary here.

Quality Improvement Projects in Michigan Helping Bend the Health Care Cost Curve

If you are concerned about what’s going on with the escalating cost of health care in this country, you should feel good about the work going on right here in Michigan.

Four programs BCBSM sponsors with Michigan hospitals have saved a combined $232.8 million over three years, lowering complication rates for Michigan patients and literally saving lives.

The Collaborative Quality Initiatives, as we call them, target health care quality, patient safety and improved outcomes. They cover some of the most commonly performed and costly areas of medical care: general surgery, cardiac and thoracic surgery, angioplasty, and bariatric surgery.

Widespread Benefits

The savings benefit more than just people who carry Blue Cross insurance. About two-thirds of the savings was spread across patients with Medicare, Medicaid or non-BCBSM private insurance and the uninsured.

We started these initiatives in 1997 when we joined five hospitals to study variation in angioplasty procedures and treatment. The initiative resulted in drastically fewer emergency bypass surgeries and other complications and saved $15.2 million in an early analysis (this program saw the largest savings — $102 million — from 2008 through 2010).

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BluesWeek: Michigan Supreme Court Order Allows Continued Growth For Accident Fund

The Accident Fund headquarters in Lansing.

On April 6, the Michigan Supreme Court ended an appeal filed by former Michigan Attorney General Mike Cox in a lawsuit against Blue Cross Blue Shield of Michigan.

The Supreme Court’s order affirms decisions of the Circuit Court and Court of Appeals that Accident Fund Holdings — a for-profit, workers compensation company and wholly-owned subsidiary of BCBSM — may own and operate its own subsidiary insurance companies, including those based outside the state of Michigan.

The Value of Accident Fund

This outcome is important to BCBSM. Blues’ ownership of Accident Fund returns significant long-term value to Blues’ health insurance ratepayers. BCBSM uses profits generated by Accident Fund to offset revenue that otherwise would have to be generated by health insurance lines of business.

Accident Fund also generates significant contributions for the state’s economy, and Lansing’s growing reputation as a national hub for insurance companies. Accident Fund is the 10th-largest workers compensation insurer in the nation, and owning subsidiaries based in other states allows the company to compete and grow its business outside Michigan. Accident Fund is headquartered in Lansing, where it employs 617 people, and last year opened a new national headquarters in a restored power plant in the heart of the city’s downtown. This new headquarters allowed BCBSM to bring hundreds of its own suburban Lansing workers into downtown Lansing to occupy Accident Fund’s former headquarters building. Accident Fund’s headquarters was constructed for growth, and it plans to remain and increase its workforce in mid-Michigan as it continues to grow its national customer base.

A separate count in the lawsuit regarding the ability of BCBSM to make capital contributions to Accident Fund is still pending in the Circuit Court, after being remanded from the Court of Appeals. We are confident the Circuit Court will follow the previous decision of the Commissioner of Insurance and rule in BCBSM’s favor, that the transfer of capital to Accident Fund from BCBSM was lawful.

If you have any questions about this ruling, please contact our newsroom at 313-549-9884.

Upcoming Event Reminder

Blue Cross and several partnering health care providers will make a major announcement about four statewide Collaborative Quality Initiatives on Tuesday, April 17 at the Blues’ Bricktown Auditorium in Detroit. The media is invited and encouraged to attend. The CQI program enlists hospitals and other providers across Michigan in comprehensive efforts to improve patient safety and clinical quality while reining in health care costs.

BluesWeek is a weekly snapshot of initiatives, events and other newsworthy tidbits under way at BCBSM

BluesWeek: Blues to Celebrate Achievements of Health Care Quality Partnerships

Blue Cross and a number of partnering health care providers will unveil new data reflecting significant achievements in four statewide Collaborative Quality Initiatives Tuesday, April 17 in Detroit. Health care reporters are invited to attend the event, which will highlight new progress made in efforts to improve patient safety and clinical quality while lowering costs in Michigan.

The Blues will be well represented at a Health Policy Symposium Friday, April 13 in Ann Arbor. Tom Simmer, the Blues’ senior vice president and chief medical officer, will appear on a policy panel, while Dr. David Share, vice president, Value Partnerships, will moderate another. The symposium, sponsored by the Center for Healthcare Research & Transformation, will explore ways to bridge the gap between health care research and policy.

Staff members at A Healthier Michigan are hard at work narrowing the field of entries for the “Make the Play for Healthy Habits” kid video contest. Readers can vote for their favorite finalists for two weeks starting April 13 on the blog. The winner, to be announced in early May, gets a school assembly with Detroit Lions quarterback Matthew Stafford and an opportunity to be a featured guest blogger.

In Case You Missed It

A federal court in Detroit has dismissed a lawsuit against the Blues by the city of Pontiac that alleged the insurer harmed competition by striking discounts with Michigan hospitals. Pontiac last year joined litigation by the U.S. Department of Justice taking aim at the discounts, which Blue Cross negotiates with hospitals in an effort to maintain access to quality health care and hold down costs.

Rate increases continued to moderate for small employer groups in Michigan during the fiscal third quarter of 2012. BCBSM announced a statewide average increase of 7 percent, compared with an average 12 percent increase over each of the last two years, a reflection of efforts to introduce more cost-effective products, promote wellness and partner with providers to improve the quality of health care. Blue Care Network’s average rate increase for small groups fell below 7 percent.

Blue Cross registered dietitian Grace Derocha, a blogger on A Healthier Michigan, stopped by the WJBK Fox 2 News studios to share her portion control props and talk about how to “Give Green a Chance” in your diet. Watch her segment with morning host Deena Centofanti here.

The Healthier Michigan Radio Show for April took a look at the how walking can improve your health. Host Ann Thomas interviewed guests Jodi Davis, BCBSM’s walking advocate and blogger, and Blues health coach and blogger Angela Jenkins. The episode is available for listening online or as a podcast.

BluesWeek is a weekly snapshot of initiatives, events and other newsworthy tidbits under way at BCBSM

Photo by UMHealthSystem

‘Total Body Health’ Junior Achievement Storefront to Educate Kids About Health Insurance and Financial Literacy

A Junior Achievement event in China.

Educating young people about health insurance and health care planning empowers them to make better choices as they grow into adulthood. This is why we are proud to partner with Junior Achievement and Quicken Loans in support of the Quicken Loans JA Finance Park to help prepare Detroit-area kids to make informed and responsible choices that impact their ability to manage personal finances and individual health. 

“Health care costs and insurance are an important part of a personal budget,” said Bridget Hurd, director of BCBSM Community Responsibility. “Teaching students about the importance of health insurance and factors that impact insurance costs, including healthy lifestyle choices, may lead them to adopt healthier habits while contributing to the overall reduction of health care costs.” 

The Quicken Loans JA Finance Park program for middle and high school students includes:

  • Twenty-seven classroom lessons
  • Curriculum aligned with Michigan Content Standards
  • Teacher lesson plans and student workbooks that cover financial institutions, debit versus credit cards, salaries and taxes, investing, budgeting, and career exploration

After students complete the Junior Achievement course work at participating schools, a field trip to JA Finance Park for a one-day simulation on budgeting is scheduled. JA Finance Park now includes a Blue Cross Blue Shield of Michigan health insurance storefront that students can visit to learn more about managing health plan choices.

At the Blue Cross “store” in Finance Park, students learn about health insurance plan premiums, copayments and costs not covered by insurance. Students visit the storefronts again and make payments for each of their purchases. At the end of the day, students receive a checkout report that tells them whether they were successful in creating a balanced budget. 

An independent evaluation in 2008 tested the knowledge students gained about budgeting through their experience at JA Finance Park. Student scores moved from 52 percent correct on the pre-test to 72 percent correct on the post-test.

More than 8,500 students participate in the JA Finance Park program each year. 

Visit jamichigan.org to learn more about our partnership with Junior Achievement, or to volunteer at JA Finance Park.

Photo by MeiGuoGuan

BCBSM and St. John Providence Health System Partner to Help the Uninsured

Leaders from Blue Cross Blue Shield of Michigan and St. John Providence Health System got together recently to celebrate a new partnership to help the growing number of uninsured in southern Oakland County and the northwest border of Detroit. The Blues awarded a two-year $300,000 grant to St. John for its St. Vincent de Paul Health Center.

The Center is located in Southfield and serves uninsured adults who have incomes at 200 percent or below federal poverty levels.

“It’s more than just the money,” said Patricia Maryland, president and CEO of St. John Providence Health System. “This partnership with Blue Cross also helps us provide the human capacity to make a difference. We understand how many individuals suffer on a daily basis because they are not able to get access to the type of care they need.”

The Health Center patients are treated by the hospital’s volunteer doctors as part of the Physicians Who Care project. Patients are also eligible for free or discounted medications through the hospital’s outpatient pharmacy.

Dr. Michael Kobernick, medical director at the St. Vincent de Paul Health Center, says that means patients with chronic diseases and nowhere else to go are able to get the care they need.

“By offering uninsured people access to health services through the St. Vincent de Paul Health Center, we’re helping to prevent expensive trips to the emergency room by managing chronic diseases such as asthma and diabetes, and providing an alternative source for acute care needs,” said Sue Barkell, the Blues vice president of Health Care Value. “This partnership between our organizations is really how we’re going to make a difference.”

The grant money will help St. Vincent de Paul Health Center do the following:

  • Increase capacity for primary care and specialty care
  • Reconfigure location to double the number of exam rooms (from two rooms to four)
  • Increase the number of patients enrolled
  • Increase focus on chronic disease management as measured by improved HEDIS scores for patients with diabetes
  • Explore implementation of electronic medical records to improve the quality and efficiency of care
  • Explore the usage of Telemedicine for specialty care visits
  • Help patients find transportation to offsite specialists

BCBSM also supports the safety net by providing $1 million in grants to free clinics throughout Michigan.