A day in the Life of a BCBSM ID card - Part Two: Eye Doctor Visit

Where is the Blues ID card traveling next? Watch part two of this four part series — Eye Doctor Visit.

In part two of this series, the Blues ID card stops at the eye doctor for an annual check- up. They say that eyes are the windows to the soul. But eyes are also the windows to health problems like diabetes and high blood pressure. Your eye doctor is sometimes the first person to identify early warning signs of health issues, while treating and helping you manage eye disorders such as glaucoma and cataracts. Keeping up with regular eye examinations can help you maintain total body health.

The Blues ID card is always on the move providing access to discounts and special offers on everything from groceries to fitness gear, and access to quality medical, dental, vision and prescription drug coverage. Stay tuned for more Blues ID card adventures.

For information about Blue Vision visit bcbsm.com/bluevision.

Special thanks to the doctors and staff of the Gaylord Eye Care Center for participating in the filming of this video.

Congratulations to Steve Anderson, winner of The Biggest Loser: Detroit Edition II!

“And the winner is…Steve Anderson!”

During last week’s nationally-televised America’s Thanksgiving Parade, Blue Cross Blue Shield of Michigan’s president and CEO Daniel J. Loepp announced this year’s winner of The Biggest Loser: Detroit Edition II. Steve Anderson beat out fellow contestants Tia Finney, Greg Czar, Calvin Poellnitz, Mary Beth Klawender and Sandy Ray to take the top spot.

All of the Biggest Loser: Detroit Edition contestants rode on BCBSM’s new “Get Fit” float during the holiday parade.

With the help of his BCBSM health coach, Grace “Dietician” Arriola-Derocha, Steve rallied to lose 55 pounds, totaling 21 percent of his original body weight.

“I cut out fast food, which I used to have all of the time. And now I eat healthier and work out,” said Steve. “I feel great and hopefully I’ll continue this for the rest of my life.”

We applaud Steve, Tia, Greg, Calvin, Mary Beth and Sandy for their hard work and dedication throughout the contest. In 11 weeks the contestants lost a grand total of 200 pounds.

We hope that they take what they’ve learned from their Blue Cross health coaches and continue to maintain their new, healthier lifestyles. 

Detroit’s Biggest Loser winner to be announced

 Biggest Loser: Detroit Edition II winner will be announced at 9 a.m. on WDIV during America’s Thanksgiving Parade live broadcast

Start your Thanksgiving Day by tuning in to WDIV-TV at 9 a.m. to see the official announcement of the Biggest Loser: Detroit Edition II winner. Who will it be: Sandy Ray, Greg Czar, Tia Finney, Steve Anderson, Calvin Poellnitz or Mary Beth Klawender? Tune in to find out!

Michigan Health Insurance Payers Collaborate in National Program to Improve Health Care

It’s really happening.  Every private, Michigan-based health insurer in Michigan, plus an additional 11 Medicaid managed care health plans, is collaborating in a project to improve patient health, control cost of care, and enhance the patient health care experience.

Michigan is one of eight states approved to participate in a Center for Medicare and Medicaid Services (CMS) demonstration project that will evaluate how to pay health professionals who improve patient care through a patient-centered medical home. Of the approximately 1,200 physicians practices expected to participate in this project nationally, approximately 480 will be in Michigan.

Michigan’s project is groundbreaking, because all health insurers have agreed to use one medical home model – the Blue Cross Blue Shield of Michigan Physician Group Incentive Program patient-centered medical home model– as the standard, rather than each health plan designing its own model.

By aligning under one medical home model, and one method of payment, all participants in the program will be able to review and share data to develop the best practices for health care improvement.

The Michigan initiative will focus on ways to address the biggest health challenges in the state – managing chronic diseases, such as diabetes and asthma, and coordinating health care across the spectrum of doctors, hospitals, pharmacies, nursing homes, etc.

“We believe this project will further strengthen the care improvements that we’re already seeing in the physician practices that participate in the Blue Cross PCMH program,” says David Share, MD, MPH, executive medical director for quality programs, Blue Cross Blue Shield of Michigan.  “We are proud to partner with physicians and health plans across Michigan in this important initiative.”

The project is one of the first to launch through the new CMS Innovation Center, a research center that will test new models for improving health care while lowering costs.

A day in the life of a Blues ID card

Part One: Doctor visit

You may think that your Blue Cross Blue Shield of Michigan and Blue Care Network ID card just sits in your purse or wallet waiting for the next time you go to the doctor or pharmacy. But did you know that those little Blues cards are actually pretty busy as they play an important role in leading Michigan to a healthier future?

Every Blues ID card is essential in helping people maintain their total body health and comes with the convenience of having a single card for medical, dental and vision services, depending on your plan. It also saves you money and helps you achieve your personal wellness goals.

Having a Blues ID card means...

• You have health coverage that helps you stay well and takes care of you when you’re sick.
• Your card is recognized nationwide when you travel because it is backed by one of the most trusted health care symbols in the country — the Blue Cross^® and Blue Shield^®.
• You have access to great Blues advantages with discounts and special offers on everything from groceries to fitness gear with the support of our Healthy Blue Xtras^SM and Blue365^® programs.

To see just how busy a Blues ID card can be, check out Part One: Doctor visit of this four part series, and stay tuned for more Blues ID card adventures.

Special thanks to the doctors and staff of Gaylord Family Practice for participating in the filming of this video.

BCBSM editorial in Crain's Detroit Business

The following is an editorial from Andrew Hetzel, vice president of corporate communications at Blue Cross Blue Shield of Michigan that first-appeared in Crain's Detroit Business on Oct. 31, 2010:

Allow the Blues to work out the best contract

On Oct. 18, the U.S. government sued Blue Cross Blue Shield of Michigan for delivering the lowest possible health care prices to our customers through the reimbursement contracts we negotiate with Michigan hospitals.

Especially now, as the government puts intense political pressure on private insurers to control premiums, it makes no sense for it to undermine the ability of insurers to negotiate the most favorable pricing we can possibly achieve.

Health care costs are straining the resources of every business and family in Michigan. BCBSM covers about 4 million Michiganders and is obligated by a 30-year-old state law to provide statewide access to health care at a reasonable cost.

None of our competitors share the Blues' statutory mission. To fulfill it, BCBSM prioritizes having contracts in place with all Michigan acute care hospitals, while ensuring that these contracts deliver exceptional value to our customers in the form of the deepest possible volume discount savings.

BCBSM's negotiated volume discounts across all hospitals, physicians and pharmacies in our network saved our customers nearly $13 billion in 2009 alone. Our payout that year approached $20 billion. The impact of that level of annual savings on the affordability of health care in Michigan cannot be overstated.

The government alleges that BCBSM is quashing competition by delivering low-price guarantees in our contracts. But competition is thriving in Michigan's health insurance market. BCBSM membership has declined over the past two years, while membership in competing HMOs has risen. There is price and service competition in Michigan. Some HMOs have aggressively acquired competitors to expand their service areas and compete with BCBSM. BCBSM, while large, has less than 50 percent market share in the majority of Michigan counties.

A tenet of American commerce is that large customer volume drives low prices. If you shop at a mega retailer — or if you are an American taxpayer served by the use of "most favored nation" clauses in U.S. government contracts — you benefit from low prices driven by volume discounts.

The same should hold true for health care. Large-volume payers such as BCBSM should have the ability to negotiate fair and reasonable reimbursement arrangements with hospitals that deliver the best possible price to our customers. These arrangements help the hospitals — which enter into them willingly — with revenue flow and a reasonable margin above their cost. They also provide our customers what they demand — low prices that keep health care more affordable.

View the original article: http://www.crainsdetroit.com/article/20101031/FREE/310319980

Biggest Loser contestants get into the “spirit” of Halloween with some healthy fall recipes

Halloween is full of tricks and treats – which can be really scary when you’re trying to lose weight. 

But the Biggest Loser: Detroit Edition II contestants are prepared. With the help of their BCBSM health coaches, they have learned that you can still get into the spirit of Halloween and stay healthy.

Pre-existing conditions hinder people’s ability to find affordable coverage in Michigan

During an Oct. 20 debate between U.S. Representative John Dingell and his opponent Dr. Rob Steele, Dr. Steele made a comment that “We have no pre-existing conditions in Michigan; we have Blue Cross Blue Shield.”

It is true that Blue Cross covers people with pre-existing conditions and does not reject them for coverage. This has been at the center of our unique nonprofit mission for decades.

The problem in Michigan is that Blue Cross's mission is unique. No other insurer -- until national reform takes full affect in 2014 -- covers the sick. This leaves Michigan consumers with pre-existing conditions with only one option. And this is where Dr. Steele's comment needs clarification.

Statewide collaboration reduces complications from surgeries; Improves quality

A collaboration among 16 Michigan hospitals has successfully reduced complications following surgery by 10 percent, during a period where there was no reduction in complications nationally.  The results are published in the October 18 issue of “Archives of Surgery.”

In the Michigan Surgical Quality Collaborative, one of nine statewide initiatives funded and founded by Blue Cross Blue Shield of Michigan, participants agree to pool data and share information about what keeps patients safe.   Physicians discuss their findings, and develop best practices that lead to better outcomes and safer practices.

The “pay for participation” approach of these initiatives fosters cooperation, rather than competition.  Blue Cross pays hospitals for their costs to collect patient data, and for the participants’ time to meet and share information.  Blue Cross also pays a third-party coordinating center – in this case, University of Michigan Health System -- to track and analyze the data.  Individual hospital results are not shared with Blue Cross, to maintain a non-competitive atmosphere.

The results are noteworthy.  For example, this initiative has reduced the number of patients who develop pneumonia from being on a ventilator following surgery.  That reduction alone could save $13 million each year.  Other successes include reductions in blood infections, septic shock, prolonged ventilator use and cardiac arrest.

Darrell A. Campbell Jr., M.D., chief medical officer at the University of Michigan Health System, leads the Michigan Surgical Quality Collaborative and believes the approach is something that should be replicated nationally. 

“If this system was adopted nationally, not just in Michigan, I think you would find a greatly accelerated pace of surgical quality improvement,” Campbell says.

Who will you inspire to start their journey towards wellness and weight loss? This is Eric’s story of how he was able to walk his way to better health.

This is the final post in a series telling the amazing stories of individuals who committed to adopting healthier lifestyles. Jodi Davis inspired Jon Stanton to change his life. Then Jon inspired Rose Borst and Eric Stanton to do the same. They have motivated each other and together they have begun a walking movement.

Motivated. Committed. Strong. Inspired. These words describe Eric Stanton, a man who lost more than 50 pounds with pure dedication and the support of his son.

Eric took his first step toward a healthier lifestyle after his son, Jon Stanton, lost more than 230 pounds by walking. After seeing the positive health effects of his son’s weight-loss, Eric was ready to take action to manage his own health.  

 See Jon’s story

He started his weight-loss journey by walking on a daily basis and changing his eating habits.  Eric made a few simple changes and so far he has lost 50 pounds. He is proud be working toward his weight loss goal and taking control of his health.

Eric knows anything is possible and he’s stepping up to the challenge with his son and their friend Rose. Together they have achieved healthier lifestyles and you can do it too. Today’s a new beginning – the start of a new, healthier you. And who knows you might just inspire someone else to do the same.

So, who will you inspire? Join our walking movement. Your success story could change someone’s life.

If you would like to learn more about how walking can work for you, visit walkytalk.com