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