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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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

To Stay Safe as a Patient, Make ‘Be Aware for Safe Care’ Your Mantra

Patient safety is a serious issue in the United States. Experts estimate that as many as 98,000 people die in the U.S. every year due to medical errors. That’s more than die from motor vehicle accidents, breast cancer, or AIDS. So it’s important to understand what you can do to stay safe when receiving care.

Blue Cross Blue Shield of Michigan is committed to being part of the solution. The Michigan Health and Hospital Association’s Keystone Center for Patient Safety and Quality — supported by BCBSM — has become a national leader in efforts to improve communication, reduce errors and prevent complications. In fact, BCBSM is in the midst of its second $6 million investment to help fund the Keystone Center initiatives, while providing incentives to hospitals to encourage participation.

BCBSM also sponsors 12 Collaborative Quality Initiatives with hospitals across the state that have reduced many types of hospital-associated infections, including ventilator-associated pneumonia, bloodstream infections, and urinary tract infections associated with indwelling catheters.

Each day, health care professionals are working together in hospitals, laboratories, pharmacies and physician’s offices across Michigan. This collaborative strength focuses on creating a consistent process of care that reduces errors, prevents complications, and improves outcomes and has made Michigan a leading state in performance improvement.

However, there is still much work to be done, and patient safety as an issue can’t be something we think about only during Patient Safety Awareness Week, the National Patient Safety Foundation’s annual campaign to raise awareness.

“The foundation’s primary theme for this year is ‘Be aware for safe care,’” said S. George Kipa, M.D., BCBSM’s deputy corporate medical director. “This reinforces the concept that all stakeholders need to be aware of and take part in the ongoing collaborative efforts for improved patient safety.”

The focus on patient safety is an outgrowth of the Institute of Medicine’s 1999 report, To Err is Human: Building a Safer Health System

What can you do to keep you and your loved ones safe?

The National Patient Safety Foundation offers good tips through its Ask Me 3 program. By understanding the answers to three simple questions, patients are less likely to make mistakes when taking prescription drugs, preparing for a medical procedure or managing a chronic condition:

  1. What is my main health problem?
  2. What do I need to do?
  3. Why is it important for me to do this?

You can also check out this brochure on medication safety.

Photo by UMHealthSystem

Why Paying Health Care Providers for Outcomes Benefits Everyone

There’s a movement among insurers policymakers and health care leaders about embracing pay-for-performance as a way to improve health care quality and lower costs. In recent weeks, Blue Cross has announced contracts based on this model of reimbursement with both Beaumont Health System and St. John Providence Health System. So what exactly will performance-based health care look like?

Blue Cross Blue Shield of Michigan recently announced a partnership with St. John Providence to launch the first such model in the state. And last week we announced a similar contract with Beaumont, ending a long-running dispute that threatened to end the hospital system’s participation with Blue Care Network.

Our goal in both cases is to construct a better system of managing patient health, with hospitals, physicians and insurers working together to increase the value of medical care provided to patients. Hospitals, in turn, would see their reimbursements improve as a reward for more successful management of the health of their entire patient population.

This approach moves dramatically away from the long-established fee-for-service model where insurers pay for every test and procedure conducted on a patient, regardless of whether patient health improves because of them.

Fee-for-service is an antiquated approach. Reimbursements climb the more tests, procedures and other services are performed. The incentive for hospitals is to churn as much volume as possible through the facility — more patients, more tests, more surgeries, more admissions and more delays in the hospital. This model has fueled the huge increases in health care costs we’ve seen in the past decade, yet it’s done little to improve patient outcomes in the U.S., which lag behind other industrialized nations.

Simmer

The new model encourages hospitals to move away from the quantity of services performed on patients in favor of quality of services. It also encourages physician organizations and hospitals to join forces and build better systems of sharing patient information and coordinating the delivery of care. Long-term, St. John Providence may well see lower utilization of things like high-tech radiation scans and even hospital admissions. But if more patients get healthier more quickly, their hospitals will benefit financially from incentive payments for achieving these goals — all of which are in the best interest of the patient.

Patients likely won’t notice any change in the quality of care they receive. If anything, they’ll encounter less frustration over redundant services and administrative headaches as the coordination of care improves.

While the details of the performance-based standards at Beaumont are pending, the Blues will support the funding of IT and other infrastructure improvements at the five participating St. John Providence hospitals until the new model begins in 2013. Some of the value-based improvements the hospitals must make include:

  • Development of a fully functioning integrated Organized System of Care all-patient registry system
  • Development of an integrated performance measurement system
  • Better coordinated processes of care so that patients have smooth transitions from their primary care physicians to specialists or hospitals
  • Capability to measure a patient’s experience with care

Patients will also notice an increase in attention from their providers. Clinical staff will be more prepared in advance for their visit, having pulled information on things like whether or not they’re up to date in immunizations or which medications they should or should not be taking. Doctors will be able to more proactively support their patients’ needs.

That leads to less redundancy, waste and time spent on administrative tasks for providers and hopefully, more time with patients.

It’s our hope that the agreements with the two Detroit-area health systems will help other hospitals realize that the performance-based model is both achievable and desirable for a better-functioning, lower-cost health care system. Many hospitals across Michigan are already expressing interest in joining us in moving to a performance-based system.

It’s been our experience through initiatives like our Patient-Centered Medical Home program that sustained efforts to improve the quality of care also helps put the brakes on runaway health care costs.

With more proactive patient care, better communication and improved coordination of care, there’s less waste in the health care system. And that benefits us all.

Thomas Simmer is Senior Vice President, Health Care Value and Chief Medical Officer for Blue Cross Blue Shield of Michigan.

Blues CEO Dan Loepp Talks Health Care Costs, Quality and Accountability on WJR’s Paul W. Smith Show

Daniel J. Loepp

Blue Cross made its presence felt at the Crain’s Health Care Leadership Summit in Detroit on Thursday. Daniel J. Loepp, president and CEO, delivered the welcoming address and earlier stopped by the WJR-AM radio booth for a live interview with host Paul W. Smith to talk about health care reform, partnering to lower costs and improve the quality of care and other topics in the news. A snippet:

Smith: We don’t know for sure the impacts of reform but we do know that there’s an opportunity to make health care work better for everyone. We need to save costs, save money, but we also need to make sure that the quality of care is there.

Loepp: Absolutely, and I think the two words that come to mind for me, and you and I have talked often about this, is accountability and responsibility, I think both on the provider’s side, the insurer’s side and the subscriber’s side. People taking care of themselves, paying attention to their health, best practices by hospitals and physicians and insurance companies. And if we can do that and we continue to talk—I was up in Marquette on Monday, I spoke to the economic club—talking about collaboration and when we do collaborate with each other and we’ve done that with the hospitals and the docs, we’re seeing savings in Michigan because of that and I think that’s part of what we’re going to talk about today.

Listen here: Paul W Smith Broadcast with Dan Loepp