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.