Blue Cross Blue Shield of Michigan - Blues Perspectives

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

2010-12-06T10:36:00.004-05:00

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!

2010-12-03T12:35:00.000-05:00

“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

2010-11-23T11:17:00.000-05:00

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!

The announcement will be made by Blue Cross Blue Shield of Michigan President and CEO, Daniel J. Loepp, before the contestants hop on the new Blue Cross “Get Fit” float. The float features physical activities you can do in Michigan such as skiing, biking and kayaking. At over 100 ft. long, the “Get Fit” float is one of the largest in the entire parade.

The Biggest Loser: Detroit Edition II is a local version of NBC’s nationally-televised Biggest Loser. Blue Cross Blue Shield of Michigan health coaches provided counseling to each contestant as part of our mission to promote a healthier Michigan. The competition, in its second year, kicked off at The Parade Company on Aug. 30 and concluded with final weigh-ins on Nov. 16.

“It’s amazing to see the progress all of the contestants have made,” said Michelle Fullerton, Blues director of Wellness and Care Management Operations. “We hope that they keep up the hard work and continue to maintain their new, healthier lifestyles.”

Biggest Loser: Detroit Edition II contestant Greg Czar steps on the scale as WDIV captures the final weigh-in.

BCBSM health coach Jocelyn Battle congratulates BLDE contestant Calvin Poellnitz on a successful weigh-in.

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

2010-11-17T14:10:00.002-05:00

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

2010-11-08T10:15:00.000-05:00

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

2010-11-01T10:24:00.007-04:00

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

2010-10-28T09:43:00.001-04:00

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.

Last week Calvin, Mary Beth and Sandy met with BCBSM health coaches Andrea Abatemarco and Tara Albosta to put together a variety of delicious but healthy dishes including an autumn stew and brownie pumpkin muffins.

“Halloween is thought of as a time for sugary food, but that doesn’t have to be the case,” said Andrea. “The recipes we made with the contestants are healthy, tasty and festive for the fall season.”

Make sure you check out WDIV’s Halloween special that will air tonight at 8:30 p.m. to see the full story.

And to follow the progress of all of the Biggest Loser: Detroit Edition II contestants check out their blogs on biggestloserdetroit.com.

BCBSM health coaches Tara Albosta and Andera Abatemarco show the contestants how to cook a healthy Halloween treat.

From left to right: Biggest Loser: Detroit Edition II contestants Mary Beth Klawender, Calvin Poellnitz and Sandy Ray pose for the cameras.

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

2010-10-22T14:00:00.001-04:00

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.

The problem in Michigan is the affordability of coverage for people who need it most -- those with pre-existing health conditions. This affordability problem arises from the fact that Blue Cross alone covers those with the most serious and expensive conditions. This drives up costs within BCBSM's pool of insured, and that cost pressure is making insurance premiums for the BCBSM pool more costly.

So there is, in fact, a coverage problem in Michigan -- despite Blue Cross being here for those who need health coverage and can't find it anywhere else. The Blues have long advocated for reform that does away with pre-existing condition exclusions and prevents commercial carriers from cherry picking only the young and healthy. While national health care reform requires that all insurers take everyone regardless of health status or pre-existing conditions starting in 2014, Michigan needs to level the playing field now.

To learn more about Blue Cross Blue Shield of Michigan’s reform efforts, please visit www.bcbsm.com/healthreform

Statewide collaboration reduces complications from surgeries; Improves quality

2010-10-19T11:47:00.000-04:00

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.

2010-10-14T11:56:00.000-04:00

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

Biggest Loser: Detroit Edition 2009 winner offers advice to current contestants

2010-10-13T13:46:00.006-04:00

It’s week 7 of Biggest Loser: Detroit Edition II and the contestants are starting to see results, but they are also feeling the psychological effects of the competition. Last year’s winner, Marilyn Kluka, knows all too well about the emotional rollercoaster they’re on right now.

Biggest Loser: Detroit Edition 2009 winner, Marilyn Kluka, talks about her weight-loss journey with WDIV reporter Shawn Ley.

Yesterday, Marilyn met with the contestants to talk about the triumphs and struggles of her weight-loss journey on WDIV’s 5 p.m. news broadcast. She talked about finding a balance between eating healthy but occasionally enjoying her favorite (but not so healthy) foods.

“Last weekend I had a wedding to go to. I knew I was going to have a glass of wine and a piece of cake. But I also knew that the next day I was going to head to the gym,” she said.

Michelle Fullerton, Blue Cross director of Wellness & Care Management, is interviewed by WDIV reporter Shawn Ley.

Marilyn emphasized the importance of staying on track and using the tools and advice provided to them by their Blue Cross health coaches. She also encouraged the contestants to keep in touch with their coach – and each other – after the competition ends.

“This is more than an 11-week weight-loss contest, it’s a lifestyle change,” she said.

Who will you inspire? This is Rose’s story.

2010-10-13T10:17:00.000-04:00

For Rose Borst, deciding to lose weight was an easy decision. After back surgery and double-knee replacement she decided that her weight was no longer going to slow her down. This is the third video in a series telling the amazing stories of four individuals who decided that they were ready to lose weight and adopt healthier lifestyles.

At 352 pounds Rose Borst slipped and fell on a sheet of ice in her driveway. Her ankle was broken. But worst of all, she could not physically get herself up off the ground.

At that point, Rose knew that it was time for her to make a serious lifestyle change.

She started eating healthy and quickly noticed results when she stepped on the scale. She read Jodi and Jon’s blogs and discovered the health benefits of walking. After recovering from her surgeries she began to add walking to her daily regimen.

See Jodi’s story

See Jon’s story

And to this date Rose has lost and kept off 130 pounds.

Rose is an everyday woman with an amazing story. She heard about Jodi and Jon and realized that if they could lose the weight, she could too. No fancy diet. No surgery. All it takes is that first step.

Now Jon’s father has become part of the “movement”. His story is the final video in the series…for now. Stay tuned to see the inspirational story of Eric Stanton.

Who will inspire you? Your success story could change someone’s life.

If you would like to share your inspirational story and find out more about how walking can work for you, visit www.walkytalk.com.

Who will you inspire? This is Jon’s story.

2010-10-12T12:40:00.001-04:00

This is the second post in a series of four 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 kept each other motivated and together they have begun a walking movement.

Jon weighed 430 pounds in 2007.

At 31, Jon had high blood pressure, high cholesterol and symptoms of congestive heart failure. When his doctor diagnosed him with Type 2 diabetes, Jon made the commitment to completely change his lifestyle habits.

Around that time, Jon received his Living Healthy magazine from Blue Cross Blue Shield of Michigan. Jodi Davis, walking and healthy habits advocate for the Blues, happened to be on the cover that issue. Jon began reading Jodi’s blog on WalkyTalk.com and corresponding with her regularly. They are now close friends and work together to inspire Michiganders with similar experiences to take the personal accountability to improve their health.

See Jodi’s story

Jon has lost 230 pounds. He didn’t have surgery. He didn’t diet. He walks or bikes on a daily basis and changed the way he ate. Jon is on a mission to help create a healthier Michigan.

Jon and Jodi’s stories are inspiring because they’re achievable. They literally improved their health by taking one step at a time. If they can do it, you can do it!

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

Questions or comments for Jon? He blogs every Tuesday on aHealthierMichigan.org

Biggest Loser: Detroit Edition II contestants stay motivated to reach weight-loss goals

2010-10-11T13:00:00.004-04:00

Losing weight is more than a physical challenge, it’s a psychological battle that can take a demanding toll on the mind and spirit. Staying motivated can be one of the most difficult aspects of losing weight.

Biggest Loser: Detroit Edition II contestants know the psychological battle with weight loss all too well. For the past seven weeks each has worked hard to stay motivated, but the journey has not always been easy.

The Biggest Loser: Detroit Edition II is a local version of NBC’s nationally-televised Biggest Loser. Blue Cross Blue Shield of Michigan health coaches provide counseling to each contestant as part of our mission to promote a healthier Michigan. The competition is in its second year of motivating local residents to lose weight and achieve a healthier lifestyle.

The contestants of this year’s competition include:

· Steve Anderson, Troy

· Tia Finney, West Bloomfield

· Sandra Ray, Taylor

· Calvin Poellnitz, Inkster

· Mary Beth Klawender, Livonia

· Greg Czar, Shelby Township

You can follow the inspiring stories of each contestant on their blogs found here: http://www.biggestloserdetroit.com, and help them stay motivated by commenting on the site and sharing links with your friends. You can also see how they continue to support one another as they comment on each others’ posts.

You can also tune in to WDIV (Local 4) to learn how Blue Cross Blue Shield of Michigan health coaches provide emotional support to the contestants, and see how last year’s Biggest Loser: Detroit Edition winner, Marilyn Kluka continues her commitment to a healthy lifestyle almost one year later.

Marilyn lost more than 70 pounds since her weight-loss journey began with last year’s Biggest Loser: Detroit Edition.

The winner of this year’s competition will receive prizes, including a spot as the honorary Grand Marshall of America’s Thanksgiving Day Parade.

2010-10-11T12:13:00.000-04:00

Who will you inspire? This is Jodi’s story.

Jodi Davis started a very healthy trend. She began living a healthier lifestyle and inspired Jon Stanton, Rose Borst, and Eric Stanton to do the same. This is the first post in a series of four that shows how one person’s lifestyle change can encourage others to make changes they never thought they could.

“One bite tastes the same as twenty,” is one piece of advice that WalkyTalk.com's blogger Jodi Davis has learned and shared with others over the years. Jodi was obese for nearly 25 years and one day, she realized she had to lose weight in order to live her life to the fullest.

Jodi is a mother of three from West Michigan who took personal responsibility for her health by beginning a daily walking regimen that brought her to a 162 pound weight loss in about 16 months. Since the weight loss, she has become Blue Cross Blue Shield of Michigan’s walking and healthy living advocate.

When Jodi is out at events—talking with the public and sharing her story—people have a hard time believing that Jodi lost the weight all on her own, without the help of diet pills or an expensive gym membership. It may sound too good to be true, but Jodi began eating the right foods and walking daily and the weight began to fall off.

Jodi’s blog on WalkyTalk.com has garnered a great deal of followers who are inspired every week by Jodi’s stories and ideas. Who did Jodi Davis inspire to lose over 200 pounds? Stay tuned tomorrow for Jon Stanton’s story.

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

Questions or comments for Jodi? Send them to jodi@ahealthiermichigan.org

BCBSM is working hard to help Michigan small businesses grow

2010-10-08T09:47:00.003-04:00

The key to Michigan’s economic recovery is the growth of small businesses.

That’s why we are developing more affordable plans such as Simply Blue^SM. This PPO plan is designed like no other and it’s the most competitively priced product that we’ve introduced in years.

Designed to give employers flexibility, Simply Blue has several deductible and copayment plan options. It can also be paired with a health reimbursement arrangement or health savings account. Employers can complete their employee benefit package with dental, vision and prescription drug plans.

In addition to the introduction of Simply Blue, our product portfolio will also include PPO and HMO wellness-based and consumer-directed health plans. These new plans will be available to small business owners on Jan. 1, 2011.

Our goal is to help small businesses attract and retain top talent by offering quality health care coverage to their employees at a cost that won’t break their budget. It’s that simple.

Now that’s how a small business grows.

New BCBSM website emphasizes the importance of total body health

2010-10-05T16:06:00.001-04:00

Many people don’t know that regular dental and vision check ups can help catch early warning signs of health problems they may not even know they have. It takes more than just basic medical care to maintain overall health.

Our new website, Healthy from Head to Toe, provides a number of interesting insights about how combining medical, dental and vision care can make you feel better and lower your medical expenses.

If you’re a business owner, Blue Cross Blue Shield of Michigan offers a combination of medical, dental and vision plans that can help your employees maintain better overall health, help reduce your health care costs and increase workplace productivity. And you can’t beat the convenience of having one ID card for medical, dental and vision services?

Visit bcbsm.com/healthyh2t to learn more.

Programs and discounts with Michigan doctors and hospitals managing costs, improving quality of health care

2010-10-01T10:03:00.000-04:00

Discounts that Blue Cross Blue Shield of Michigan negotiates with health care providers and collaborations with physicians and hospitals have realized more than $13 billion in savings, according to the 2010 Annual Report of Program Value (PDF), released Friday.

We’ve gone on record saying that one of our biggest concerns with health care reform is a lack of measures to contain costs. That concern is also echoed by many business owners, many of whom will have to begin offering insurance to employees in the coming years.

That’s why we feel it’s important to spotlight the important work taking place to lower costs and improve health care quality right here in Michigan.

The report outlines savings on hospital, professional, pharmacy and dental rates for members that total $12.9 billion.

In addition, the Blues work with more than 8,100 physicians and more than 40 hospitals across the state on projects that address factors that drive up costs and diminish the quality of health care. A few examples:

Doctors participating in our Physician Group Incentive Program saved nearly $9.5 million in 2009 through more judicious use of high- and low-tech radiology services.
An initiative to increase use of generic drugs helped save $700 million over seven years.
A collaborative initiative targeting angioplasty in hospitals saves an estimated $15.2 million annually and has reduced both hospital deaths and post-procedure blood transfusions by nearly a third.
A cardiac surgery initiative has decreased incidence rates of post-surgical prolonged ventilation, saving $25,000 per case.
And our Patient-Centered Medical Home program, at 1,800 participating physicians, is the largest in the nation and is beginning to see positive effects in just its second full year. Preliminary data have shown that PCMH practices have lower rates for adult and pediatric inpatient admissions, radiology utilization and ER visits than non-PCMH practices. Comprehensive data on first-year results of the program are expected later this year.

Blue Cross is proud of these accomplishments, of course because they are saving valuable health care dollars, but more importantly, because they are creating a safer, higher quality atmosphere for health care in Michigan for everyone.

Body & Soul BLUE Challenge entrants mark the midpoint with an outpouring of spirit

2010-09-30T13:47:00.001-04:00

Only the serious showed up at Fuller Park in Grand Rapids on our recent squishy Sept. 11.

But, they were enough.

The hardy band of cold, damp souls I met at the park was there to mark the midpoint of this year’s Body & Soul BLUE Challenge, a three-month wellness competition between 11 African-American faith communities around the city. The Blues are co-sponsors of the Challenge along with the American Cancer Society.

Participants had free massages awaiting them in the park, a Zumba^® warm-up, rows of health and fitness vendors, a group walk to the Fulton Street Farmers Market and discount tokens for the goods they’d find there.

That persistent rain had no chance of causing a wash-out.

There was too much heart there for that to happen.

And, if you’re unsure about that, just check out this video from that day:

Or consider that participants in last year’s Challenge, which was won by Ms. Moody, who you’ll meet in the video, and her husband Rev. Nathaniel’s church, logged a whopping 167,000 miles. About 49,000 of those miles were from members of Moody’s Brown Hutcherson Ministries alone.

Considering the date, an observer couldn’t help but think a lot about transformation as he walked around the park. I asked everyone I spoke to that day whether they were seeing lives being changed and every one of them came back with an emphatic yes.

Holding such an event in the African-American community makes a certain amount of sense. It’s true that many African- Americans are at high risk for many serious and often fatal diseases, some of it lifestyle-driven, some of it not.

But, I quickly found out that there was much more at work here.

The bulk of the conversation that came back to me that day was about how taking care of the body is a spiritual act in itself. Others talked about having a responsibility to their spiritual selves to be as fit as they can be. “Bringing together the health and well-being of whole communities,” BCBSM’s Cle Jackson called it.

This year’s Body & Soul Challenge will end Oct. 2 at the Grand Rapids African American Health Institute Rhythm Run at Martin Luther King Park in Grand Rapids.

But, in a more important sense, Body & Soul won’t end that day … or on any other. It can’t, really.

People were changed through their participation, this year and last.

Transformed.

I saw fuller lives at Fuller Park. It’s tough to go back once you’ve been there.

Lack of cost containment, onerous tax reporting among biz concerns over health care reform

2010-09-28T15:50:00.001-04:00

What can Michigan businesses expect as federal health care reform gains momentum?

That was the big question being asked during a Health Care Reform: Defined event and panel discussion Tuesday at the Detroit Regional Chamber.

The answer, of course, depends upon many factors, including the shape of yet-to-be-written regulations and how the Nov. 2 election shakes out in both Washington, D.C. and Lansing. But the consensus was that businesses will likely need help both from tax and employee-benefit advisors as well as from statewide insurance exchanges set to be established in 2014.

One of business’ biggest concerns about the Patient Protection and Affordable Care Act was the lack of measures to contain costs, experts said. That concern is echoed by Blue Cross Blue Shield of Michigan (video), which holds a membership in the Detroit Regional Chamber.

“There is a tremendous amount of uncertainty that still lies within the whole PPACA”, said Michael Embry, vice president and senior account director for Comerica Insurance Services. A law that already stands at more than 2,000 pages could balloon to more than 10,000 pages and 1,700 separate regulations once completed, he added.

One regulation that many businesses would like to see jettisoned was a 1099 reporting requirement that will force rigorous tracking of payments to vendors, said Joseph Rankin, a partner in the employee benefit consulting group at Plante & Moran.

“The best thing I can say to employers is surround yourself with good advisors on all aspects of PPACA,” Embry told attendees.

While panelists agreed that the reform law could see changes if Republicans win control of Congress, they were divided on how far-reaching those changes could be. Republicans are unlikely to win enough seats to gain the veto-proof majorities necessary to repeal the law outright, said Peter Pratt, the owner of Public Sector Consultants in Lansing who oversees the firm’s health care consulting.

What’s more, Pratt said, every attempt to cut out costs from the law will decrease subsidies intended to help lower costs for business owners and plan members.

Experts agreed that the tax credits to be offered under the law may not be enough to entice small-business owners to start offering health insurance to employees. That makes the statewide insurance exchanges “an enormously important way of getting potentially affordable health insurance to the people,” Pratt said.

“If you don’t do the exchanges right in 2014, you’re going to have a lot of unhappy people,” he said.

Concerns over escalating costs of providing health care could force more employers to seek alternatives and trade-offs to traditionally benefit-rich PPO plans, said Kirk Roy, vice president of national health reform for BCBSM.

Roy added that reform would likely further the push away from a traditional fee-for-service payment model toward bundled payments that manage health of overall patient populations. The Blues are also likely to further expand programs such as the Patient-Centered Medical Home model that expand the role of primary care as a way to contain costs.

“The whole value proposition of, ‘are we getting what we pay for’ is going to become an issue,” Pratt added.

Check out a video webcast of today’s panel. You can also view the Blues’ statement on health care reform from Daniel J. Loepp, president and CEO, in the video below.

Health reform at 6 months: No more exclusions or waiting periods for children with pre-existing health conditions

2010-09-23T12:02:00.000-04:00

National health reform turns six months old on Sept. 23, when a variety of new rules and regulations take effect. In this weeklong series, we highlight how benefits will change for consumers in the near term. You can also find videos, news alerts, RSS feeds and other information at our health reform website.

Those of you who are parents know that there are few things worse than having a sick child, especially when their condition requires serious and oftentimes costly medical attention.

The good news for parents is that the Patient Protection and Affordable Care Act will ban the practices of pre-existing condition exclusions and waiting periods for children under the age of 19.

Before national health reform passed, health insurance companies could turn away kids if they had a pre-existing health condition, such as asthma, diabetes or even cancer.

If the insurance company did agree to cover them, they would sometimes impose a 6- to 12-month waiting period before coverage kicked in. In other words, the family would be responsible for paying out-of-pocket for the condition until the waiting period was over. Waiting periods are intended to prevent people from enrolling in a health plan only when they’re sick, creating a riskier and more costly insurance pool.

Starting with plan years beginning on or after Sept. 23, families will have more options in getting coverage for children with pre-existing conditions. Blue Cross Blue Shield of Michigan and Blue Care Network have longstanding policies of accepting everyone for coverage, including children, regardless of health history. The Blues will remove waiting periods for children on Jan. 1, 2011, unless the start of their plan year falls on a different date.

Other insurers that are not currently required to offer coverage to everyone will now be required to accept children under age 19 regardless of health status for a certain time period each year. The government has yet to clarify when this period will be and how long it will last.

Health care reform puts an end to the widespread insurance practice of denying coverage to patients of any age for pre-existing conditions in 2014. Until then, commercial health insurance companies in Michigan may continue to cherry-pick the younger, healthier patients, while the Blues continue to offer coverage to anyone who needs it, regardless of health status or pre-existing health conditions.

In the meantime, the Blues will continue to advocate for reforms here in Michigan that would require all Michigan health insurance companies to guarantee access to coverage for everyone.

Health reform at 6 months: Protecting your choice of doctor and access to emergency services

2010-09-22T11:42:00.001-04:00

Much was made during the reform debate about protecting peoples’ rights to choose their own doctor and have access to emergency services without worrying about higher costs if they go to an out-of-network emergency room. Within a part of the legislation, called “The Patient’s Bill of Rights,” there are requirements around these two issues. So what does that mean to you?

Choice of health care professional:

If you are in a health plan that has a network of physicians, you have to choose a primary care provider in that network. That’s something we’re all pretty used to doing. The law now says that parents can elect to have a pediatrician serve as their child’s primary care provider as long as that doctor is in the network.

Sometimes, you can’t see a specialist unless your primary care provider gives the okay. However, the law now says that women must have direct access to a health care provider who is authorized by the State to provide obstetrical or gynecological care without a referral or prior approval as long as that provider is in the network. This is aimed at giving women more flexibility in determining what kind of care is right for them.

People can make these choices without prior authorization from their insurer or a referral from their doctor. For more specifics about these options, see our “Patient’s Bill of Rights” reform alert.

Under Michigan law, Blues members have had flexibility in choosing OB/GYNs or pediatricians as primary care providers for a long time, so they are not really impacted by this regulation.

Coverage of emergency services

If you have the misfortune of getting seriously injured or sick while out of town, the last thing you want to worry about is if you’ll have to pay through the roof for seeking emergency care away from home. The reform legislation aims to alleviate this concern.

Now plans that provide any benefits for emergency services in hospital emergency departments must provide that coverage without prior authorization or higher fees for out-of-network emergency services.

Since all Michigan hospitals participate with the Blues, our members are always covered. And our connection to the entire Blue Cross Blue Shield system ensures they have access to quality emergency services when they venture out of state. While we have to make some minor administrative tweaks, the Michigan Blues are already mostly compliant with this regulation. For more details, see our “Patient’s Bill of Rights” reform alert.

Health reform at 6 months: The sun sets on lifetime dollar limits for care

2010-09-21T10:28:00.001-04:00

Lifetime dollar limits on care will go the way of the 8-track tape, pinball machine and floppy disk when the federal health care reform law hits the six-month mark.

The Patient Protection and Affordable Care Act bans lifetime dollar limits for what it deems “essential health benefits” effective Sept. 23. The prohibition applies to all health plans, new or grandfathered, for plan years that begin on or after that date.

If you previously reached a lifetime dollar limit, your health plan will be required to offer you re-enrollment during a special 30-day open enrollment period, most likely later this year.

Blue Cross Blue Shield of Michigan and Blue Care Network will hold its special open enrollment period from Nov. 1 through Nov. 30. The coverage-effective date is Jan. 1, 2011, with the exception of groups that have a plan year that begins between Sept. 23 and Dec. 31. In this case, the coverage-effective date is the plan year start date.

Here are additional details of this provision:

The regulation does not apply to individuals who reached a lifetime dollar limit while covered by a contract that was not renewed or is no longer in effect.
It does apply to family members who lost coverage due to reaching a lifetime dollar limit if other members of the family are still covered by an active policy.
Plans must notify affected individuals how and when they are eligible to re-enroll.
The open enrollment period must occur no later than the first day of the first plan year beginning on or after Sept. 23. Coverage must start according to the same timeline.

The measure is part of the new “Patient’s Bill of Rights” created by the reform law.

Health reform at 6 months: Free checkups and tetanus shots, anyone?

2010-09-20T10:06:00.003-04:00

Health insurers will be required to cover a host of preventive services and immunizations with no cost sharing for members under a requirement of national health reform soon to take effect. Cost sharing is when health plans – or employers offering health plans – require members to cover some costs associated with their coverage, such as co-payments for doctors’ office visits or for medications.

The requirements apply to preventive services, such as annual checkups, vaccinations and children’s wellness visits starting with plan years beginning on or after Sept. 23, 2010. Blue Cross Blue Shield of Michigan and Blue Care Network are covering the specified services with no cost sharing for services received by providers that participate in our network.

Blue Cross Blue Shield of Michigan and Blue Care Network already provided many of these services with little or no cost sharing prior to passage of health reform but are working to implement the new rules for all group and individual plans. For most Blues members, the rules take effect with plans that begin Jan. 1, 2011.

Various panels of experts and advisory committees have determined the list of evidence-based preventive services and immunizations that must be covered with no cost-sharing. They include:

Certain screenings for cancer
Diabetes preventive services
Counseling for smoking cessation
Routine childhood immunizations
Periodic tetanus shots for adults
Preventive care for children up to age 21, including:

Regular pediatric visits
Vision and hearing screening
Developmental assessments
Counseling to address obesity
Certain immunizations and preventive screenings

The federal government is currently developing its list of preventive services and screenings provided to women and expects to issue guidance by Aug. 1, 2011.

When preventive services are added by the panels of experts and advisory committees, health plans will be required to cover the services for plan years that start one year after the date of the new recommendation.

However, certain cost sharing may be charged to members, depending upon how a provider bills for services. Check out our related health reform alert for more information. While you’re there, be sure to subscribe to receive reform alerts via e-mail or RSS directly from the Blues.

You can view the full regulations at the U.S. Health and Human Services health care reform website.

Health reform at 6 months: Eligibility for dependent coverage extends to age 26

2010-09-20T10:03:00.001-04:00

With health care reform approaching the key six-month milestone, we’re reminding people that employers and health insurers will be extending coverage to dependents up to age 26 during a special enrollment period this fall.

Blue Cross first announced an agreement in April between the federal government and health carriers regarding the continuation of dependent coverage to age 26. Starting Sept. 23, the provision will apply to nearly all group and individual health plans.

Previously, dependents over the age of 18 often could only be kept on their parents’ policies so long as they were in college and not married. The new reform law loosens these restrictions.

Under the new rule, employers that offer dependent coverage must extend coverage to their employees’ dependent children who are under age 26, even if they are eligible for employer-sponsored group coverage through work. The same goes for insurers offering dependent coverage to those enrolled in plans in the individual market.

Dependents under age 26 whose coverage previously ended when they reached an eligibility threshold must also be offered the chance to re-enroll.

The rule does not kick in until 2014 for grandfathered group plans where the adult child is eligible for other employer-sponsored coverage. You can read more about grandfathered group plan exceptions and other details of the rule here.

Adult children who need to enroll must be given 30 days to enroll regardless of whether the plan or coverage offers an open enrollment period during that time.

BCBSM and Blue Care Network will hold its special enrollment periods for adult children from Nov. 1 through Nov. 30. The coverage effective date for enrollment is Jan. 1, 2011, with the exception of groups that have a plan year that begins between Sept. 23 and Dec. 31, 2010. In this case, the coverage effective date is the plan year start date.

Groups that routinely offer open enrollment from Oct. 1 through Dec. 31 may use this period to enroll those impacted by this provision, provided it is at least 30 days in duration.

2010 West Michigan Policy Forum Highlights the Impact of Health Care in Michigan

2010-09-17T12:51:00.000-04:00

Yesterday and today business leaders and state and local lawmakers from across Michigan are gathering in Grand Rapids for the 2010 West Michigan Policy Forum. While in Grand Rapids their goal is to discuss, develop and strengthen regional policy and goals to further improve our state. Blue Cross Blue Shield of Michigan and Blue Care Network are key sponsors and supporters of this event.

Health care challenges concerning west Michigan business leaders will be one of the main discussion points during the conference.

Jeffrey L. Connolly, president for West Michigan Operations and Managed Care for Blue Cross Blue Shield of Michigan (bio: http://bit.ly/9FaYmP), is joining other leaders from the health and medical industries in a rapid exchange session titled The Impact of National Health Care on Friday, Sept. 17. Discussion topics will range from health care reform to regulatory issues to affordable health care for small businesses.

Having your voice heard in regards to Michigan’s future should be important to everyone, especially when it relates to the future of health care. Do you plan on attending the conference? What health care topics would you be most interested in hearing Michigan’s leaders discuss? We’d like to know your thoughts.

For more information about the 2010 West Michigan Policy Forum visit: http://www.grandrapids.org/policyforum.

Blue Cross kicks off wellness efforts across the state

2010-09-10T12:41:00.000-04:00

September is here, and it’s a perfect month for getting back into the swing of a schedule, especially with kids going back to school. It’s also a great time to start a regular exercise regime and slip other healthy choices into our daily routines.

Blue Cross Blue Shield of Michigan and Blue Care Network are sponsoring several fun community wellness initiatives to help Michiganders get moving and motivated to live healthier this month.

Join the movement (literally!) and participate in one of the events going on in local communities:

While Blue Cross is here to take care of you when you’re sick, we’re also here to help you stay healthy and fit all year round.

All of these events are focused on living well and promoting healthier life choices for everyone. Healthy eating and benefitting from physical activity - it’s all part of how we’re leading Michigan to a healthier future. Won’t you join us?

Technology, medical equipment driving health care costs

2010-09-09T11:04:00.002-04:00

The rising cost of health care has been a topic of intense national debate over the past two years, as legislators, health care experts and insurance companies ponder the reasons for the high cost of care and explore possible solutions.

Most studies addressing the reasons for rising health care costs put technology at the top of the list.

As Blue Cross Blue Shield of Michigan President and CEO Daniel J. Loepp pointed out at an employee meeting, “Everyone today wants the newest, the best equipment. And every new machine costs significantly more than the last. As a culture, we demand the newest and best.”
What he didn’t say, but implied, was that the newest, the best and the most expensive don’t necessarily correlate with better health care.

That’s a point that the Kaiser Family Foundation made in a background brief on health care costs at KaiserEDU.org. Here’s an excerpt:

Some analysts state that the availability of more expensive, state-of-the art technological services and new drugs fuel health care spending not only because the development costs of these products must be recouped by industry but also because they generate consumer demand for more intense, costly services even if they are not necessarily cost-effective.

In addition to the high cost of technology and prescription drugs, the online health policy resource cited the following factors as primary drivers of rising costs:

Greater prevalence of chronic disease
Aging of the population
Administrative costs

The background brief went on to include a number of ideas for controlling costs; among them, launching initiatives designed to improve quality and efficiency. It noted that higher spending on health care in certain geographical areas does not correspond to better health outcomes.

Improving health care quality and efficiency is exactly what Blue Cross Blue Shield of Michigan is doing through its Value Partnerships program. This joint collaboration among hospitals, physicians and the Blues is improving health care quality and outcomes, while lowering health care costs.

Key to the success of Value Partnerships is a series of quality initiatives and the industry-leading Patient-Centered Medical Home Program. Learn more at valuepartnerships.com and let us know what you think.

Heart attack survivor realizes value of the Blues

2010-09-08T12:23:00.001-04:00

When we talk about the cost of health care, it’s easy to get caught up in statistics: the numbers that illustrate the rising cost of care and the dollars that Blue Cross saves the health care system through its various collaborative initiatives.

What often gets lost in the sea of numbers is the personal stories — the tales of men and women whose lives have been transformed by care made affordable by Blue Cross Blue Shield of Michigan insurance.

One such man is John Otterbacher, a psychotherapist and sailing aficionado who has struggled with heart problems since he was in his late 40s. He had his first heart attack in 1996, and has subsequently undergone eight separate heart procedures.

We first became aware of John when he sent a letter to Carolyn Willemsen, the editor of Living Healthy, our magazine for Blue Cross Blue Shield of Michigan members. Following is an excerpt:

I’ll cut to the chase: I wouldn’t be alive without you guys. Thank you.

John estimates the cost of his various procedures is in the hundreds of thousands of dollars. “I could never have afforded that treatment without Blue Cross Blue Shield,” he wrote in a follow up e-mail.

He goes on to tell about one memorable experience: “A call from my intensive care bed to an unknown angel at Blue Cross Blue Shield who approved coverage of a Medivac flight to Milwaukee for a specialized form of open heart surgery.”

But John’s story goes far beyond his cost of care and how Blue Cross gave him access to the best medical treatment money could buy.

At the heart of his story is his realization that life is about much more than simply surviving from one heart procedure until the next.

“My wife and I had been talking about going sailing for years, so I made a deal with her. I told her that if … I lived until June we’d go sailing,” Otterbacher recalled in an article in the fall issue of Living Healthy. “She laughed, and then she realized I was serious. She said, ‘It’s a deal.’”

When he woke up the next morning, he felt like he had entered a whole new world.

“My goal wasn’t just to survive. My goal was to get strong enough and confident enough to go sailing. That really saved my life in the end ― the dream of going out there with Barb and the kids gave me my life back.”

Otterbacher began to work his way back to health, and was working out at the health club two days after he left the hospital following his last open heart surgery. He also started to prepare his sailboat, Grace, for an ocean crossing.

In October of 1998, Otterbacher, his wife, Barbara, and their two young daughters, Erin and Kate, began their journey across the ocean. They were away for six years and made four ocean crossings, sailing more than 30,000 miles. They lived in Europe and explored places such as Africa and the Caribbean.

“It was quite a family outing,” Otterbacher said. “But life is short, and spending time with my family is the most valuable thing I could do. The reality of our adventure greatly exceeded the dream.”

Their family adventure is chronicled in his award-winning book, “Sailing Grace.” Otterbacher has optioned the rights to make the book into a movie, with the screenplay set to be completed by January.

To find out more about Otterbacher’s story, visit his website at http://www.sailing-grace.com, where you can also view an excerpt from his DVD titled “More than Survival.”

General Motors shows off new models during Ride & Drive event in Detroit

2010-09-02T11:46:00.000-04:00

General Motors recently brought a fleet of new vehicles to the Blue Cross Blue Shield of Michigan headquarters in Detroit for a Ride & Drive promotional event with Blues employees.

Check out this video interview with Wendy Stachowicz of GM’s Vehicle Advocate Program, who talks about the company’s approach to involving its partners as brand ambassadors for new vehicles.

New Blue Cross partnership with U-M, Michigan hospitals aims to clear risk of blood clots in patients

2010-08-31T14:14:00.002-04:00

Colloquially speaking, venous thromboembolism may not be much of a conversation starter. But the medical condition more commonly known as the blood clot plays a key role in driving up medical costs and preventable deaths in the U.S.

That’s why the Blues are partnering with the University of Michigan Medical Center and 16 other hospitals to reduce the risk of blood clots in hospitalized patients. It’s the latest of our ongoing efforts to improve patient care across the state.

Hospitalized patients have a higher risk of developing blood clots due to surgery, prolonged periods of immobility, use of certain medications and the presence of other conditions like obesity or congestive heart failure. Patients who develop VTE while hospitalized tend to experience longer hospital stays, poorer clinical outcomes and various ongoing complications.

In fact, blood clots constitute the most common form of preventable hospital death, according to the Agency for Healthcare Research and Quality. The condition affects an estimated 900,000 Americans each year, with more than half acquiring VTE while in the hospital or within 30 days after leaving. About 300,000 die from it.

The new partnership, which launches Oct. 21, will focus on VTE in patients hospitalized for medical – not surgical – reasons. It could save as much as $5 million in five years.

This is the eighth collaborative quality initiative that the Blues sponsor for Michigan hospitals.

These partnerships encourage competing hospitals to collaborate, share and analyze data on common but costly procedures such as heart surgery and bariatric surgery in an effort to improve patient safety and lower costs.

The programs have saved millions of dollars in reduced complications, infections and mortality. They have improved the quality of health care delivery for all Michigan residents.

For more information, check out our 2010 Partners in Health Care Report.

Tags: blood clot, health care quality, cost of care, patient safety, collaborative

Biggest Loser: Detroit Edition II contestants to be revealed Monday, Aug. 30

2010-08-27T11:32:00.002-04:00

Blue Cross Blue Shield of Michigan is teaming up with WDIV-TV and The Parade Company to announce participants in The Biggest Loser: Detroit Edition II.

The six Biggest Loser: Detroit Edition II finalists will be revealed during the WDIV newscast on Monday, Aug. 30, beginning at 4 p.m. During the announcement, BCBSM President and CEO Daniel J. Loepp will be interviewed by Chuck Gaidica during the 5 p.m. newscast.

This year, 310 people entered the contest. That’s 100 more applicants than last year. The applicants were narrowed down to 60 who were called back for audition interviews. From there, the final six were chosen.

With the help of Blue Cross health coaches, the finalists will participate in the weight loss competition that will run into November. The winner of the competition will be announced during WDIV’s coverage of America’s Thanksgiving Parade, and all six contestants will ride on the BCBSM float.

Last year’s winner, Marilyn Kluka of Farmington Hills, lost 47 pounds during the 11-week competition and was one of six contestants who lost a total of 270 pounds.

Health insurance 101: Explaining hospital charges and patient costs

2010-08-24T12:27:00.001-04:00

[Eighth in a series of posts to help you better understand health insurance and how recent changes affect you.]

If you’ve ever glanced at an Explanation of Benefits form, you know that it contains a confusing array of dollar figures, all for the same medical procedure.

The often wildly divergent figures illustrate how the modern health care system works.

For the sake of illustration, let’s say you go to the hospital, where you receive an outpatient colonoscopy procedure. And let’s say the hospital charges $2,000 (not necessarily a true average charge, but let’s use it for our purposes here.)

But “charges are not the same as cost,” as Ellen Ward, a project manager in Hospital Contracting and Policy for Blue Cross Blue Shield of Michigan, points out. “Charges are typically much higher than the total cost of providing a service.”

In setting their charges, hospitals look to recoup their operating, capital and other costs, as well as losses from providing uncompensated care. But most also bake in a profit margin, and that mark-up in price can range widely.

Because insurance companies have an understanding of the actual costs of providing services, they try to negotiate closely to that figure ― say, cost plus a 3 percent margin.

So back to our colonoscopy. While the hospital wants to charge $2,000, let’s say the true cost is $1,000. Depending on the hospital and the negotiated rate, an insurer may agree to pay $1,030 ― or cost plus 3 percent.

Of course, different insurers set rates differently, but most try to provide good coverage at the best price for their members.

“I think all insurers want to do the same thing, but it comes down to how much leverage you have,” Ward said. “Because we have such a large proportion of covered individuals in Michigan, we can negotiate a better price than an insurance company that doesn’t have a lot of leverage with a hospital.”

Patients aren’t responsible for the difference between the provider’s charge and the insurer’s allowed amount, but their plan may require a copayment, coinsurance or deductible. However, those charges are calculated against the allowed amount, not the hospital’s charge.

So if you had a 30 percent co-pay for your colonoscopy, your charge would be 30 percent of the $1,030 negotiated rate, or $309.

Other posts in this series:

Health insurance 101 – How to read your Explanation of Benefits ( EOB)

2010-08-17T10:02:00.003-04:00

[Seventh in a series of posts to help you better understand health insurance and how recent changes affect you.]

Many people find their Explanation of Benefits statements difficult to understand or confuse them with a bill.

Different insurers use different terms and formats, so you should direct specific questions to your insurance company. But here’s a general guide for how to make sense of your EOB:

First of all, you’ll notice the name of the doctor or facility that billed your insurance company. The location may be unfamiliar if you had lab work or an X-ray, which is often read in a different location.

Look for the date of your procedure or service visit. This could differ from the date of your visit for the same reason as above.
Next, look for the procedure code. Insurers often use this in place of a written explanation of what procedure you had done to protect your privacy in case your EOB falls into the wrong hands.
“Member’s Deductible” or “DED.” This figure, if one is listed, is the amount that was applied to the deductible on your policy.
“Copay Amount.” This is the amount, if any, that you were supposed to pay in the office at the time of service.
“Co-Ins” stands for co-insurance. This is the amount, if any, that is your responsibility after your insurer pays its portion.
“Adjustments.” Here you will see any adjustments to what the provider billed and what the insurance plan allows. You should only have to pay the amount that the insurance allows. If a doctor’s office charges you for the unadjusted amount, contact your insurance company to determine whether the office is a contracted provider – meaning it agrees to accept an insurer’s negotiated payment amount as payment in full. If not, you may be responsible for the difference.
“Insurance Paid” or “Amount Paid.” This states how much of the bill was paid by your insurer.
“Patient Responsibility,” “Your Balance” or “Your Responsibility.” This is the remaining balance after your insurance plan has paid its portion of the bill, minus any adjustments, including any copay, co-insurance and deductible amounts. This amount should match the amount that your provider bills you.

Next week: Provider charges vs. what insurers pay

Health insurance 101 – A glossary of common insurance terms

2010-08-10T13:49:00.004-04:00

[Sixth in a series of posts to help you better understand health insurance and how recent changes affect you.]

Confused about health insurance? You’re not alone.

The health care industry is a highly regulated, complex delivery system with multiple stakeholders, including you as a consumer and the insurance plan that helps you pay for care. And in an era when costs are rising, insurance plan benefit designs are changing and health care reform heralds big changes, it’s not easy staying informed.

To help you make better sense of the intricacies of your insurance plan, we’ve put together a reference glossary and explanation of health insurance basics. You can also check out our companion posts exploring emerging trends and products in health insurance.

What is a health insurance premium?

A premium is the amount that an individual policy-holder or, if you have coverage through your job, your employer pays to a health plan each month to purchase health coverage.

What’s a deductible?

A deductible is a fixed amount that a subscriber (the person who is covered by the insurance plan) is required to pay each year toward his or her medical services before the insurance company will begin to pay for services.

For example, if the insurance company specifies a $250 annual deductible, the subscriber must pay for medical services until that amount reaches $250 for the year. Then, the insurance company will begin to pay a portion of the costs.

The use of deductibles reduces the cost of premiums by sharing some of the risk with subscribers. It also helps predict the overall expected costs for a group.

What is a copayment?

A copayment is either a fixed dollar amount or a percentage paid by the subscriber for medical services. Once a subscriber pays an agreed-upon copayment, the insurance carrier pays the balance.

For example, the subscriber pays 25 percent of the total cost for services, and the insurance carrier pays the remaining 75 percent.

The use of copayments reduces overall expenses for insured groups because the subscriber is sharing costs. It also gives the subscriber an incentive to use fewer services, one factor contributing to health care cost inflation.

What is coinsurance?

Coinsurance is a provision by which an insured individual shares in the cost of certain expenses; sometimes the term is used interchangeably with copayment.

At Blue Cross Blue Shield of Michigan, we use the term copayment to designate flat dollar amounts, while coinsurance refers to percentage amounts. For example, if a person is responsible for a percentage of a particular charge, it is considered coinsurance.

What is an Explanation of Benefits, or EOB?

An EOB is a statement mailed to a subscriber or insured individual explaining how and why a health insurance claim was or was not paid. There are various types of EOBs, but all have the same general format and contain the same claim information. An EOB is not a bill. Your care provider (doctor, hospital, clinic, etc.) will send you a bill.

You can also find a comprehensive glossary of health care terms on our corporate website.

Next week: How to read your EOB.

See also:

Blue Cross proposal protects Michigan’s most vulnerable seniors, while giving all seniors deep discounts on Medigap coverage

2010-08-06T16:45:00.002-04:00

Blue Cross Blue Shield of Michigan filed a proposal with our regulators today that would provide Michigan seniors with monthly discounts of $48, $64, $75 or $96 off the full price of our most popular Medicare Supplemental insurance plan, also known as Medigap.

Medigap is optional insurance that pays for many of the out-of-pocket costs that are charged when seniors visit the doctor or hospital.

The annual dollar value of the BCBSM Medigap discounts would be $576, $768, $900 or $1,152. The variations are based on seniors’ income – with those who have the lowest income getting the biggest discount on their health care.

BCBSM is the only insurer in Michigan that provides a discounted Medigap product. BCBSM is assessed 1% of our total revenue by the state every year to fund the discounts. This assessment totaled more than $180 million in 2009.

Providing discounts based on income is a change from how discounts are applied today. Currently, discounts offered by BCBSM are applied evenly across our Medigap subscriber base. Seniors who earn six-figure incomes receive the same break on their Medigap policies as do low-income seniors who depend on Meals on Wheels for the nutrition they need to remain independent.

With the cost of health care rising, BCBSM is concerned about some low-income seniors not being able to afford Medigap – even with the hefty discount we provide.

In fact, under this new approach, low-income seniors would receive a $16 monthly reduction in their Medigap premium. Almost nowhere in the nation are health insurance premiums going down. We can make it possible by realigning our discounts to give a greater share to the lowest-income.

When you squeeze the balloon like that, you reduce the discounts provided to the middle- and upper-income seniors. This has the affect of increasing their monthly premiums.

But we believe that Michigan will support providing a little extra help to poor seniors – and we ask our Medigap members for their support as well. If you are enrolled in our Medigap Plan C and earn between $32,000 and $85,000 a year, your premium will be about $15 a month higher. That’s about 50 cents a day that you are investing in keeping health care within reach for someone your age that is getting by on less than $16,245 a year. And your overall discount will still be significant – $64 every month, or $768 a year.

BCBSM will continue to provide deep discounts to all Michigan seniors who independently enroll in our Medigap plans. We are asking for your support to provide a little extra help to those seniors who need it most.

Andrew Hetzel

BCBSM Vice President, Corporate Communications

2nd Annual Buy Michigan Now Health Festival

2010-08-04T11:33:00.001-04:00

Blue Cross Blue Shield of Michigan presents the 2^nd Annual Buy Michigan Now Festival in downtown Northville Friday, August 6. The event supports health and wellness and the growth of Michigan business.

The 3-day festival features sidewalk sales, children’s activities, and Michigan-based businesses and Michigan-made products. Dieticians will be on site to answer questions and offer free blood pressure screenings, nutritional consultation, and fitness demonstrations.

Paul W. Smith from WJR is broadcasting live at the event discussing the importance of a healthier Michigan and growing Michigan based companies. The broadcast event will encourage people to ask questions and share stories about Michigan business and the local community.

To join the conversation on creating a healthier Michigan, visit ahealthiermichigan.org.

Health insurance 101: Health savings accounts help consumers fill gaps in coverage

2010-08-04T10:24:00.001-04:00

[Fifth in a series of blog posts to help you better understand health insurance and how recent changes affect you]

As we’ve noted throughout this series, consumers are shouldering more responsibility for their own health care spending. New consumer-directed health plans incorporate tools to ease the burden and help individuals make smarter decisions regarding their care. One way is through health savings accounts.

An HSA allows you to pay for current health care expenses not covered by your high-deductible health plan and save for future ones, all on a tax-free basis. The account is funded by the employee, the employer, or both, but the account is owned by the employee. Leftover balances can be rolled over from year to year.

Pairing an HSA with a high-deductible health plan, which generally doesn’t cover the first several thousand dollars of your health care expenses, can be a smart way to go for some. Withdrawals are tax-exempt when used to pay for qualifying medical expenses, and contributions to an HSA reduce your taxable income.

Money used to pay for nonqualified expenses, however, is subject to a 10 percent tax penalty, an amount that rises to 20 percent after Dec. 31, 2010. A partial list of qualified medical expenses is available on Publication 502 at irs.gov.

When you set up an HSA, you determine your annual contribution. You can estimate these needs by:

Reviewing your eligible expenses from the previous year
Determining how your upcoming expenses may differ from the previous year

For 2010, your contribution cannot exceed the maximum of $3,050 for individual coverage or $6,150 for family coverage. A variety of other rules apply, but money not used during the year rolls over to the next year and can earn interest tax-free. You can also place your unused funds in a longer-term investment through the bank that administers your HSA.

You can contribute money directly, through deductions from your tax return, or via withdrawals from your 401(k) or other retirement plan. Employer contributions are not subjected to payroll taxes.

The use of health savings accounts has risen dramatically since being introduced in 2004. The ranks of Americans who supplement their health plans with HSAs was expected to rise as high as 45 million by 2010, from 438,000 in late 2004.

Next week: A glossary of health insurance terms

WalkyTalk.com is full of inspiration, motivation and conversation

2010-08-02T09:24:00.001-04:00

Blue Cross Blue Shield of Michigan’s walking and healthy habits advocate Jodi Davis wants you to start living a healthier life. Why? Because she did and you can, too. Jodi lost over 160 pounds and has kept it off for nearly 8 years. Her secret? Walking and eating right.

Jodi has been BCBSM’s walking advocate since 2007 – and she is still just as passionate about helping others start a walking regimen and stay away from unhealthy foods. Take a look at this excerpt from Jodi’s recent blog :

“I’m here to help you “step-by-step” along your weight-loss journey. I am that person who believes you can do this… that you WILL do this!”

You can read Jodi’s blog on WalkyTalk , where Jodi shares thoughts, stories, articles, photos and more. Check out the blog and leave Jodi a comment – she would love to hear from you!

Search for WalkyTalk.com on Facebook and look for Jodi on twitter at twitter.com/WalkyTalkJODI.

Taking Health Care to the Next Level with Healthy Blue Living Rewards

2010-07-21T17:16:00.000-04:00

Blue Care Network introduces Healthy Blue Living Rewards^SM, Michigan’s first outcome-based HMO plan that rewards people with lower insurance costs for improving their health and achieving healthy results.

This product is an extension of our already successful Healthy Blue Living^SM product. It makes health care more affordable by taking personal accountability to the next level by lowering copays and deductibles for people who achieve healthy goals.

Healthy Blue Living Rewards’ goal is to improve people’s health, thus building a healthier workforce. This plan looks at specific health measures people can manage such as tobacco use, weight, blood pressure, cholesterol, and blood sugar.

What makes Healthy Blue Living Rewards different from other health care products? Well, this is the second outcome-based wellness product we’ve launched this year, with Healthy Blue Outcomes (link: http://www.bcbsm.com/outcomes/) being the other. These two outcome-based products are unique in Michigan and are among the first such products to be offered anywhere in the country.

Healthy Blue Living Rewards is a product the business community has been asking for, and BCN is once again first to market with an innovative and affordable solution. You can learn more about Healthy Blue Living and Healthy Blue Living Rewards by visiting MiBCN.com/hbl.

Health insurance 101: How Blues plans reward individual wellness

2010-07-21T10:04:00.001-04:00

Fourth in a series of blog posts featuring frequently asked questions about health care insurance.

Last week, we discussed the rise of consumer-directed health careamong insurance plans. Those plans sometimes involve provisions designed to encourage or even reward individuals who lead healthy lifestyles.

What incentives are insurance companies offering to members for pursuing healthy lifestyles?

An emerging subset of consumer-directed health plans involves wellness and care-management initiatives. These plans give members the opportunity to lower their premiums and copayments by taking steps to improve their overall health, such as quitting smoking or losing weight.

The Michigan Blues offer a variety of wellness-focused plans through the Healthy Blue Choices^SM portfolio. Healthy Blue Outcomes^SM, our newest product beginning July 1, rewards people who demonstrate tangible improvements in their health with more affordable health insurance coverage.

All of our Healthy Blue Choices programs ask members to complete online health assessments and meet certain health criteria. They encourage participants at risk for certain chronic conditions to speak with health coaches about their personal health issues, goals, treatment options and ways to improve their overall health.

Next week:The rise of health savings accounts.

Energy-efficient lighting to swath Detroit-area parking facilities in green

2010-07-15T12:05:00.002-04:00

An exterior lighting makeover under way at seven Blue Cross parking locations in Southeast Michigan is expected to save the same amount of energy that 1,000 homes use in a year.

Electricians are working to replace exterior lighting at parking facilities in Detroit, Southfield and South Lyon. The effort, part of the companywide Blues Go Green initiative, is expected to reduce energy consumption by up to 50 percent and deliver $43,800 in electricity savings each year.

“We’re going from a metal halide to an inductive fixture,” said Christian Meyer, engineering manager with Blue Cross’ Facilities and Support Services division. “Inductive is a breed between a fluorescent and a metal halide.”

The lighting being replaced is characterized by high wattage for light output, long relight times and high maintenance costs.

By contrast, the induction lighting boasts an instant relight time, lower maintenance costs and other benefits. “These fixtures maintain their luminescence or their light output over their lifetime a lot longer than the metal halides,” Meyer said.

Federal energy-efficiency tax credits and rebates available from DTE Energy will make up nearly half the project’s cost. When combined with the utility-bill savings, the Blues expect the project to pay for itself in a little more than two years.

“Since the (lighting) prices came down, and with the green initiatives that are coming from our utilities and the federal government, we couldn’t turn down this project,” Meyer said.

The Blues and DTE earlier this week announced a plan to construct a 200-kilowatt rooftop solar array on one of Blue Cross’ downtown Detroit parking structures. The array is expected to produce about one-fifth of the company’s Lafayette campus base power.

The Blues Go Green initiative targets ways the company can be more environmentally friendly and save money. Perhaps the best-known example is the “living roof” on our parking deck in downtown Detroit, which helps to control stormwater runoff and also extends the structure’s lifespan, among other benefits.

Work on the lighting replacement project is expected to wrap up in late July.

Electricians assemble new inductive lighting fixtures ahead of final installation at downtown Detroit parking deck.

Health insurance 101: The rise of consumer-directed health care plans

2010-07-13T13:16:00.001-04:00

Third in a series of blog posts featuring frequently asked questions about health insurance.

As we discussed in last week’s post, employers are passing more of the costs of health coverage to employees. In response, insurers are offering health plans that help individuals better absorb expenses and use their health care dollars more wisely.

What is meant by consumer-directed health care?

Blue Cross Blue Cross Blue Shield of Michigan introduced CDH plans in 2005 amid a growing number of employers that were dropping health care benefits altogether or requiring their employees to contribute more toward their premiums. Today, we market them under the umbrella term Healthy Blue Choices™.

CDH plans are credited with exposing employees to the true costs of their health care. Broadly speaking, they typically employ three different funding mechanisms. Each is designed to help you pay for eligible medical expenses, including deductibles and copayments, that otherwise are not covered under a health plan:

An employer, subscriber or both contribute money into a non-taxable health savings account (HSA) used to pay for a health plan or other qualifying medical expenses.
Employers may elect to set up health reimbursement arrangements (HRA), in which they set aside money to reimburse employees for qualified medical expenses.
Employers can also offer a flexible spending account (FSA), a tax-favored program that allows subscribers to pay for eligible out-of-pocket health and dependent-care expenses using pre-tax dollars.

Consumer-directed health plans are touted as member-centered health plans that give you options and control over your health care. You get a choice of health care plans and tax-free funding options that have the added bonus of reducing your income-tax liability.

Next week:Newer Michigan Blues plans reward individual wellness.

Healthy Blue Xtras partner to appear on NBC show tomorrow night

2010-07-12T16:48:00.000-04:00

Jonny Kest, owner and instructor at Center for Yoga, will be helping a Detroit family fight their battle with the bulge on tomorrow night’s episode of “Losing It with Jillian” at 8 p.m. on NBC.

Center for Yoga is a partner of Healthy Blue Xtras^SM – a savings program from Blue Cross Blue Shield of Michigan and Blue Care Network that offers members discounts on healthy products and services.

Check out the Healthy Blue Xtras site to find out what discount BCBSM members can get at Center for Yoga.

And don’t forget to tune in to NBC tomorrow night at 8 p.m to see Jonny. After the episode, leave us your comments. We’d love to hear your thoughts.

Health insurance 101: Rising costs spur changes in health plan designs

2010-07-07T16:17:00.001-04:00

[Second in a series of blog posts to help you better understand health insurance and how recent changes affect you.We welcome your comments and questions]

As health care costs rise, the types of plans offered to employees are expanding. The following is a frequently asked question:

My employer provides me with health insurance but keeps asking me to chip in more money to cover costs. Why can’t I just get a PPO that covers everything without asking me for any contribution, like before?

In general, the percentage of employers that offer group health insurance plans to employees is on the decline, a side effect of rising health care costs. Although the rate of premium costs has slowed in recent years, premiums continue to rise faster than inflation and wages.

While Blue Cross Blue Shield of Michigan still offers high-quality PPO plans, today’s health care market is shifting more toward consumerism, where individuals are encouraged to take control of their personal wellness and health care spending. And yes, that means employers who offer group coverage are offering high-deductible health plans that ask employees to share more in the costs of their coverage.

In the wake of laws enacted in recent years, insurers have begun offering plans that help individuals better absorb these expenses and use their health dollars more wisely.

Next week: A look at some of those plans in greater detail.

See also:

· Costs are rising. What’s a consumer to do?

Michigan leads the way for patient-centered medical homes

2010-07-02T15:07:00.004-04:00

Michigan is at the forefront of improving the way primary health care is delivered. The largest patient-centered medical home program in the nation is in our state, with 1,800 physicians in 500 practices now designated as a Blue Cross Blue Shield of Michigan patient-centered medical home.

The medical home is a primary care practice in which a health care team is completely focused on the goals and needs of each patient. Health problems are detected and treated earlier. The team coordinates patients’ care and guides them as they make their way through the health care system.

National health care leaders and policy makers are watching Michigan to see how the program is working, including it in national and state health reform discussions.

Another 3,200 primary care doctors across Michigan are working to implement patient-centered medical home capabilities into their practices, affecting almost 2 million residents.

A recent news release about patient-centered medical home posted on this site a few weeks ago discussed the preliminary data showing that PCMH-designated doctors are improving patient care.

You can find the new list of 1,800 PCMH doctors here.

Still Wondering What the Benefits of PCMH are for Patients?

Take a look at this slide presentation we put together to help individuals understand what’s in it for them.

Patient-Centered Medical Home (PCMH): The Benefits of a Team Approach to Health Care

View more presentations from Blue Cross Blue Shield of Michigan.

BCBSM applauds senior advocates with Claude Pepper Award

2010-07-01T14:58:00.001-04:00

Age didn’t stop anyone at the Wayne County Senior Fun Fest on June 26. It was remarkable to see hundreds of seniors from across metro-Detroit gather for an afternoon filled with music, dancing and even bingo!

Blue Cross Blue Shield of Michigan honored two senior advocates and one organization for their commitment to seniors and outstanding volunteer service at the event. The individuals were honored with Claude Pepper Awards for their professional or volunteer efforts that have made significant contributions to improving the lives of Michigan seniors.

The award recipients received a $1,000 check to give to the nonprofit organizations of their choice. The honorees are:

Julius Martin of Flint was honored in the working-advocate category. Martin is a certified nurse’s aide at Bortz Nursing Home, where he is considered one of the finest health care workers that serve the elderly. Martin puts forth an extra effort to be there for the residents by helping them make phone calls to their families, reading cards and letters to them, talking with them about life accomplishments, and driving them to special events such as family reunions. Ultimately, he improves the lives of older adults by respecting their culture and helping them stay connected to earlier life experiences and family memories.

John J. Villa of Beverly Hills was honored in the retired category. At 92 years young, Villa has the zest of a teenager and refutes some of the stereotypes people tend to associate with seniors. The Villa Wellness Center, named in his honor, benefits more than 350 elderly residents of Southwest Detroit each year. Seniors are able to enjoy the center’s wellness activities including water aerobics, Zumba® dance, tai’chi, field trips, parties and health fairs.

The Redford Senior Citizen Club received this year’s Diana C. Jones Award for members’ exemplary service in the community and their advocacy efforts to keep seniors informed. Under the direction of president Louis Kisic, members of the Redford Senior Citizen Club live up to it’s mission of “believing that life is a great adventure, and to live it happily and usefully.” The club provides a positive place for seniors to come interact and be informed about important issues affecting their daily lives.

Senior citizen advocates and volunteers are not always properly recognized for their important contributions to the community. Do you know someone who is committed to improving the lives of the elderly?

Pictured from left to right: Julius Martin, Claude Pepper Award winner; Robert A. Ficano, Wayne County Executive; Louis Kisic, Redford Senior Citizen Club President, Diana C. Jones Award winner; Diane Webb, Wayne County Commissioner for District 9; Nancy Bryk, accepting award for John J. Villa, Claude Pepper Award winner; and Ilona Varga, Wayne County Commissioner for District 5.

Become a winner by “losing”

2010-07-01T10:50:00.002-04:00

Mark your calendars and grab your scale.

Win by Losing, Blue Cross Blue Shield of Michigan’s popular weight-loss competition for group customers, is ready to kick off another exciting round of friendly competition on August 30.

Last year, the Blues launched this creative weight-loss challenge as a way for group customers to motivate their employees to create a healthier workplace by shedding those unwanted pounds.

Since the Blues launched the first round of the competition in the fall of 2009, participants from across the state have discovered the benefits of achieving healthier lifestyles. Between two rounds of competition, Win by Losing contestants have lost a grand total of 5,532 pounds – more than two and a half tons of weight.

Registration for the next round of competition starts on August 23. In the meantime, check out this video of some of the winners from the last round of competition and find out how they became the top “losers.”

Visit bcbsm.com/yourhealth to learn more about the competition.

Health insurance 101: Costs are rising. What’s a consumer to do?

2010-06-29T13:56:00.002-04:00

[First in a series of blog posts to help you better understand health insurance and how recent changes affect you.]

Let’s face it: Health insurance can be a dry and complicated business. And it’s not easy deciphering the various concepts, jargon, and not-exactly-household words that define the business of insuring your health.

But your health insurance is important. And with health care reform, ever-rising costs for care and other trends that are transforming the industry, it’s a good idea to keep yourself abreast of what the changes mean to you.

That’s why we’ve put together this guide to help you understand what’s happening in health insurance, why it’s happening and what it means for you.
My health care costs are going through the roof. What gives?

Overall health care spending is indeed rising – to $2.5 trillion in 2009 or 17.3 percent of the economy, according to the Centers for Medicare and Medicaid Services. It’s projected to balloon to $4.5 trillion by 2019, or more than 19 percent of Gross Domestic Product.

Many factors are driving up benefit costs. In general, pricing is based on increasing demand for health care and the ready supply of providers able to meet the demand.

Demand is rising in part because of changing population demographics and treatment options. The U.S. population is aging, with seniors spending more on health care than children or working-age adults. Personal health habits or traits such as smoking, obesity and lack of exercise are also increasing the rates of chronic conditions like diabetes and heart disease. That’s leading to more frequent doctor visits and higher use of more costly medical tests, procedures and hospital stays.

In fact, almost half of all health care spending is used to treat just 5 percent of the population.

On the supply side, health care manufacturers and other suppliers constantly invest in research and development, and providers continuously invest in new technologies to improve their capabilities for treatment. All of these expenses are passed along to the consumer and result in higher costs for care.

Lastly, salaries for health care professionals are competitive and may be higher in regions where, for example, registered nurses are in short supply. Hospitals in Michigan are also providing more uncompensated care due to the downturn of the economy and the increasing numbers of uninsured patients that they treat. All of these factors are passed along in the end to consumers.

Next week: Rising health care costs are spurring changes in health plan designs

Fitness, fun and fireworks!

2010-06-24T16:14:00.000-04:00

As more than a million people eagerly awaited the launch of thousands of fireworks above the Detroit River on Monday, June 21, Blue Cross Blue Shield of Michigan, Local 4 and the Parade Company awaited a launch of a different kind.

High atop the Miller Parking Garage at the Flip Floppin Summer VIP Rooftop Party, the stage was set for the triumphant return of the Biggest Loser: Detroit Edition.

During WDIV’s live broadcast of the Target Fireworks, BCBSM Senior Vice President of Group Sales & Corporate Marketing, Ken Dallafior spoke with on-air anchors Carmen Harlan and Devin Scillian about Blue Cross’ commitment to leading Michigan to a healthier future. And, how that commitment is a driver in Blue Cross’ support of the Biggest Loser: Detroit Edition II.

Ken Dallafior talks with Carmen Harlan and Devin Scillian during WDIV’s fireworks broadcast

Also during WDIV’s fireworks broadcast, Michelle Fullerton, BCBSM Director of Wellness & Care Management Operations, was interviewed by Local 4 meteorologist, Chuck Gaidica. They talked about the success of last year’s contest by visually demonstrating the weight lost by the six 2009 Biggest Loser: Detroit Edition contestants. A total of 17 colorful buckets were each filled with approximately 16 pounds of sand to represent the 270 pounds lost by last year’s contestants.

Chuck Gaidica and Michelle Fullerton surrounded by sand buckets to show amount of weight lost by 2009 contestants.

Entries are being accepted for this year’s contest at ClickonDetroit.com through July 21. Six lucky finalists will then be selected to compete in the waistline battle of a lifetime. Each contestant will be paired with a Blue Cross health coach for guidance and support in their weight loss. The contest will run Aug. 30 through Nov.16. The winner will be announced live during WDIV’s broadcast of America’s Thanksgiving Parade.

At three-month mark, the Michigan Blues are well-positioned for reform implementation

2010-06-23T10:28:00.000-04:00

Yesterday at the White House, many of the values that guide my company’s approach to insuring people’s health were on display once again as President Obama brought insurance industry leaders together to mark the 91^st day of the Patient Protection and Affordable Care Act, otherwise known as health care reform.

President Obama spoke about the progress that’s been made in the three months since he signed the health care reform law. Much of that progress, however, is consistent with longstanding business practices and values of Blue Cross Blue Shield of Michigan.

Insurance rescissions are now a thing of the past. At BCBSM, kicking people off of coverage because of a change in their health status was never part of our business.

Covering children, regardless of their pre-existing conditions, is required. At BCBSM, we go far beyond – covering children and all adults without regard for health status.

Young adults now have the ability to remain on their parents’ coverage. At BCBSM, we never cut graduating seniors loose just for receiving a high school or college diploma.

Our chief executive officer, Daniel Loepp, attended the events at the White House and shortly after recommitted BCBSM to the success of health care reform.

Here in Michigan, there’s been a tremendous effort put forth by Blue Cross Blue Shield of Michigan and our various partners to beat reform deadlines and implement changes in the spirit of the new health care law. While making these changes, we’ve continued to fulfill our unwavering commitment to the health of Michigan’s people, communities, businesses and health care system.

Health reform remains controversial. Implementation is a long and confusing journey. Stakeholders will be affected in different ways. As the state’s leading health insurer, Blue Cross is expected to be a trusted resource with it comes to health issues, and that includes health care reform. Today we launched bcbsm.com/health reform – a website to help everyone in Michigan understand the impact of the law.

Health reform has changed some things. One thing it hasn’t changed is our longstanding commitment to covering people, and leading Michigan to a healthier future.

Andy Hetzel
Vice President
Corporate Communications

BCBSM and Wayne State University working to keep young talent in Michigan

2010-06-21T16:15:00.000-04:00

Businesses across the state are struggling to keep young talent in Michigan. Cuts, layoffs and restructuring are the norm, leaving young graduates desperate to find new and creative ways to break into the workforce. With a struggling economy, especially in the Detroit area, many are choosing to leave the state in an effort to find entry-level work. Blue Cross Blue Shield of Michigan and Wayne State University are taking the reins to end this “brain drain” phenomenon here in Michigan.

Wayne State University and BCBSM are both working to brand Detroit as a destination for young talent. David L. Williams, Dean of Wayne State’s School of Business Administration, emphasizes the importance of promoting the city of Detroit as a great place to work and live, and a place where young talent has opportunities to develop and eventually advance in the workplace. This will increase their interest in choosing to stay in Michigan.

Blue Cross Blue Shield of Michigan has implemented an extensive internship program to provide college students with real world experience, so valuable in gaining entry into the workforce. Interns are presented with substantive projects related to their area of interest or field of study.

Yan Isayev, a Blue Cross Blue Shield of Michigan intern, was recently recognized as Intern of the Year by Crain's Detroit Business. Currently on internship number four at BCBSM, Isayev has no doubt that he wants to stay in Michigan after he graduates.

The future of Michigan is dependent upon recruiting and retaining educated, talented and creative people. What can local business do to stop Michigan’s brain drain?

View the story below for an in-depth look into just how Blue Cross Blue Shield of Michigan and Wayne State University are working to keep the best and brightest in Michigan.

Take Steps for Crohn’s & Colitis

2010-06-21T14:16:00.005-04:00

Millions of Americans suffer from Inflammatory Bowel Disease (IBD) – many of them right here in Michigan. IBD includes Crohn’s disease and a related disease, ulcerative colitis.

Participants in the 2010 Take Steps Walk for Crohn’s & Colitis are walking together on the Detroit River Walk to build awareness – with the hope to one day find a cure for these painful and unpredictable digestive diseases.

All Blues employees, family and friends are invited to participate in the second annual UAW-BCBSM/BCN Joint Programs Take Steps for Crohn’s and Colitis Walk to benefit the Crohn’s & Colitis Foundation of America. The event will be held Saturday, June 26, beginning at 5 p.m. Registration is open now and through the day of the event.

Put your walking shoes on and join the fight against Crohn’s and colitis. Walkers will enjoy the beautiful Detroit RiverFront, while they work to build a healthier community.

To learn more about Crohn’s and colitis, visit the Crohn’s & Colitis Foundation of America website.

The Man Up! Campaign takes men’s health to another level

2010-06-18T13:46:00.001-04:00

A recent study by the Centers for Disease Control and Prevention has shown that death rates of African American men have far exceeded those of their Caucasian counterparts. Taking into account the leading causes of mortality, African American death rates have sky-rocketed up to approximately 40 percent higher than that of Caucasians.

To address this issue, sponsoring partners 100 Black Men of Greater Detroit, Inc. and Blue Cross Blue Shield of Michigan held a men’s health breakfast titled, “Man Up!: Championing the Health of African American Men to Create a Healthier Michigan,” on Monday, June 7, 2010 at Fellowship Chapel in Detroit. The program aimed to encourage African American men to take more initiative and ownership in their personal health and wellness.

A panel composed of cancer survivors and medical professionals provided their insights on how to help alleviate the harsh statistics of prostate cancer within the African American community. Dr. Isaac J. Powell, a professor at Wayne State University and the Karmanos Cancer Institute, reached out to men through his story of how he survived prostate cancer—simply by making a constant point to receive the necessary treatments. Former Detroit Lion, Freddie Scott also shared his testimony of how he fought cancer by “keeping and acting out on faith.” Through their testimonies and expertise, Powell, Scott and the rest of the speakers each stressed the importance of routine check-ups, screenings and receiving more effective treatments for prostate cancer overall.

William Toples, Director of Community Responsibility for Blue Cross, and the Chair of Health and Wellness for 100 Black Men of Greater Detroit, Inc, provided some insight on the issue of men’s health in the African American community, stating, “African American men, specifically, just don’t go to the doctor.” To get more of the community involved, Toples encouraged people to save the date for the sponsoring partners’ next event, which is the Man Up! Men’s Health Walk. The walk will take place on September 11, 2010 at Belle Isle Park. “This walk is critically important and we want to show all of southeastern Michigan how important this partnership is.”

Our commitment to a healthier future

2010-06-16T13:35:00.000-04:00

The statistics are compelling. A healthier future is not just about health care legislation, but about people being involved in taking better care of their own health. Dan Loepp, President and CEO of Blue Cross Blue Shield of Michigan, emphasizes to National Management Association members that without personal responsibility, lives will continue to be lost and costs will increase.

The Blues are leading the way to a healthier future by strengthening collaborations with health care providers, promoting patient safety and investing in partnerships that improve quality of care. We are reaching out to youth by supporting community and school programs that teach exercise and healthy eating. We are the leader in offering wellness-based heath care plans that help manage member costs by rewarding healthy behaviors.

Being accountable for our own health contributes to a healthier Michigan.

BCBSM Intern Yan Isayev wins Crain’s Intern of the Year

2010-06-14T14:33:00.000-04:00

Four-year BCBSM intern, Yan Isayev serves as a prime example of what it means to “make every experience a learning one,” which is why he has been respectfully noted as Crain’s Detroit Business 2010 Intern of the Year. With Isayev being well into his fourth internship with the Blues, he has exceeded far beyond the company’s expectations, considering the fact that Blue Cross doesn’t have a formal rotational internship program.

Isayev’s experience with Blue Cross has consisted of developing competitive analyses of product development, evaluating and improving internal websites and tools, and leading projects to improve recruitment and retention. Currently, his position at the Blues deals with supporting the vice president of the membership and claims processing systems, as well as providing analytical research to improve both internal and external processes. Isayev will be graduating this December from Wayne State University, earning a bachelor’s degree in honors finance.

Overall, BCBSM is fully committed to building a healthier Michigan by providing educational opportunities to young people and retaining talent within the state.

MyBlue helps Michiganders through their career transition

2010-06-08T10:53:00.005-04:00

As companies are downsizing or finding ways to improve their bottom line, many Michiganders are now finding themselves without health insurance from their employer. It’s not an ideal situation, but in the midst of this tough economy, many individuals and their families are being forced to make changes in their daily lives – finding individual health insurance just happens to be one of them.

Looking for individual health insurance is a task many have not had to face before. Blue Cross Blue Shield of Michigan knows how important it is to have options when it comes to health care coverage. How do you get the most health care coverage at the lowest cost? What plans will fit your needs? The Blues offers MyBlue^SM, a suite of individual coverage options for Michigan residents, designed to protect your health and your finances at your specific stage of life.

Not sure what MyBlue plan will fit your needs? Check out bcbsm.com/myblue and click on the AskBlue icon. AskBlue is an interactive program that helps make the complicated process of selecting an individual health plan easy to use and easy to enroll.

Everyone should have access to health care coverage. As times change, the Blues are leading the way to help Michigan’s residents to a healthier future.

Medical home: Looking good so far.

2010-06-04T11:01:00.000-04:00

Today, we announced meaningful, forward progress in the Michigan Blues'

Patient-Centered Medical Home program. In looking at initial pieces of data, we found that Patient-Centered Medical Home (PCMH) practices are changing the way they practice medicine to be more attuned to their patients' ongoing needs. In fact, we found that patients in PCMH practices have lower hospital admissions, fewer ER visits and lower use of radiology services.

So what does this mean to you, the average patient? It means your PCMH doctor will manage your care on an ongoing basis and will work with you to help you reach your health goals. You won't just see your doctor when you are sick - your doctor will keep tabs on you even when you are well. It means your PCMH doctor will help you learn to manage your diabetes or asthma or high blood pressure, so little problems don't become bigger problems that end up with you in the ER or hospital. It means your PCMH practice knows you, has all your health records and is available to you by phone 24-hours a day. Simply put, PCMH is your home for health.

At Blue Cross Blue Shield of Michigan, we think the Patient-Centered Medical Home will change health care for the better. We feel so strongly about this model of care, that we've invested several years in working with our physician partners to develop our PCMH program. And, as you'll see in this news release, it looks like the PCMH program is working.

Follow the Mackinac conference on aHealthierMichigan

2010-06-02T12:47:00.001-04:00

The Detroit Regional Chamber’s annual Mackinac Policy Conference opens up today, and the Blues have got you covered as the region’s top business and policy minds gather for three days on Mackinac Island.

Starting today, the home page of our new aHealthierMichigan site will feature a special Mackinac Policy Conference design. There, you’ll find regularly updated blog posts from the Blues team and guest bloggers, as well as a live Twitter feed of all tweets sent with the conference’s #mpc10 hash tag. We’ll also have a media section with conference-related news.

The conference comes as both Detroit and Michigan look for new ideas to rebuild their economies. And as usual, the conference is stocked with heavyweight speakers, including Sergio Marchionne, chief executive of Chrysler Group LLC; U.S. Health and Human Services Secretary Kathleen Sebelius; and former U.S. House Speaker Newt Gingrich. Check out the full agenda conference here.

We hope you follow along with what promises to be an exciting, thought-provoking three-day discussion. As always, you can follow us on Twitter @bcbsmnews and @healthierMI.

The Blues Anti-Fraud Unit Recouped More Than $270 Million

2010-05-26T16:10:00.001-04:00

Blue Cross Blue Shield of Michigan’s health care fraud investigation unit, the oldest and most successful health plan operation of its kind in the U.S., saved or recovered nearly $277 million since it first began operation nearly 30 years ago.

During 2009 the BCBSM anti-fraud unit acted on 2,300 tips involving suspected fraud. Its investigations led to 149 arrests and 94 convictions, and resulted in nearly $15 million saved or recovered in 2009 alone. Health care fraud constitutes nearly 3 percent of all health care spending, according to the National Health Care Anti-fraud Association.

"Our anti-fraud activities help ensure that critical health care dollars are being spent appropriately," said Daniel J. Loepp, BCBSM president and CEO.

Telephone calls to BCBSM’s toll-free, anti-fraud hot line are the starting point for most investigations, with explanation of benefits statements to Blues’ members prompting approximately 70 percent of all hot line calls when members notice irregularities on their statements. BCBSM also has an online method of reporting fraud through its website.

The unit’s members have law enforcement backgrounds in surveillance, undercover work, credit card fraud and narcotics, while others come from inside the company with experience in auditing, security and nursing.

If you or anyone you know has information about suspected health care fraud in Michigan please call the BCBSM toll-free, anti-fraud hotline at 800-482-3787, between 8:30 a.m. and 4 p.m. Monday through Friday.

Click here to learn more about The Blues’ anti-fraud efforts.

Alternative medicine partnership’s a natural for members

2010-05-24T16:02:00.000-04:00

Are you on a healthy road?

If you’re a Michigan Blue Cross member interested in alternative approaches to health care, we’re working to better serve your needs. Through our Blue365 partnership, we’ve teamed with Healthyroads, Inc.^TM, a health improvement and wellness subsidiary of American Specialty Health Incorporated.

Healthyroads offers savings on products and services in the areas of:

Chiropractic
Exercise and movement
Massage and bodywork
Wellness and fitness centers
Mind and body relaxation techniques
Diet and supplement advisors
Vitamins and supplements
Acupuncture (under development)

How does the program work?

To participate in the program, members pay an annual $25 fee to receive discounts of up to 25 percent with 25,000 complementary and alternative medicine providers nationwide.

Or, members can pay an annual $25 fee to get discounts or best pricing at participating affinity fitness club and exercise centers.

Want both? You pay only $40 to receive discounts at alternative providers and participating fitness clubs.

The new Healthyroads program augments our array of other member discount programs, including Healthy Blue Xtras^SM and Blue365.

To access Healthyroads, Log into the member secured portal and go to Blue365 (Health and Wellness tab). From there, Healthyroads can be found under the Healthy Choices tab (Wellness).

About Our Request to Increase Individual Product Premiums

2010-05-21T15:28:00.002-04:00

On May 21, 2010, BCBSM requested approval for premium increases for our health plans for individual consumers under age 65. The mere fact that BCBSM requested approval is important. We are the only health plan in Michigan that must obtain regulatory approval for new premiums in the individual market – and we are the only health plan that is transparent to the public with individual market rate requests.

Many Michigan consumers are struggling, no doubt. The economy is challenging. In fact, many people who obtain individual health coverage from BCBSM need it because their jobs have been lost, or their employers have stopped offering coverage. We recognize and respect these personal struggles.

But BCBSM – by law – must run a self-sustaining health insurance business. We lost $94 million on these individual products in 2009.

As much as our regulators have control over the prices we set in the individual market, they also rightfully demand that our company be financially sound. That is the only way for BCBSM to accomplish its unique mission and serve its longstanding safety net role in Michigan health care – accepting applicants, regardless of their medical history or condition. We must run a financially sound business in order to continue this role.

BCBSM is requesting a 7.8% increase for its individual "PLUS" group conversion products and a 9.9% increase for its individual "PLUS" products. Other individual products and group conversion would receive 15% and 12% increases, respectively. Here are some answers to basic questions people might have about these proposed rate increases:

Why are you asking to increase my rates?

These increases apply only to products offered to individuals, under age 65, who are not covered by employer group plans. We are very sensitive to the economy and its impact on our subscribers, but we cannot allow medical costs to continue to increase without adjusting our rates. So we are trying to strike a delicate balance between doing the right thing for our business and our subscribers. These increases are lower than the rates the company should have requested to break even on our individual product line. Even if BCBSM is granted the full increases we requested, we expect medical costs to continue to exceed premiums in our individual line of business, and we expect to lose at least $40 million on these plans in 2011.

How much are the requested increases?

Rates would vary based on the product, and recommended rates for all products are provided in our public filing with the state. BCBSM is transparent on its rate setting in the individual market, and we believe regulators should consider requiring all other health insurance companies to be equally clear with consumers before they increase their individual premiums.

Why is BCBSM experiencing losses on individual products?

BCBSM is the only health insurance company in Michigan that never rejects people with serious medical conditions for enrollment. As the individual market has grown, and as all other health plans in Michigan continue to reject people who are more expensive to cover, BCBSM’s individual insurance pool (all the people we cover in the individual market) has grown more costly to insure.

The result is that Blue Cross every year spends significantly more paying for medical costs for our individual subscribers than we collect in premiums. This will continue to be the case, even if we are granted the full increases we are requesting. Even with the premium increases requested today, BCBSM anticipates it will lose between $40 million and $60 million on under-age-65 individual products in 2011.

But I am healthy. Why are my premiums increasing?

BCBSM community rates its individual plans – which means that our premiums do not discriminate between someone who is healthy, and someone who is unhealthy or who requires more frequent medical services to maintain their health.

Why can’t BCBSM use its reserves instead of raising rates?

Our reserves exist to provide security for all of our nearly 4.4 million subscribers – ensuring that the company that covers their health needs is financially sound. The membership in our individual plans is about 200,000 people. BCBSM pays out more than $2 million every hour in medical and pharmacy claims. Our reserves are far below the maximum cap set by state law. Court decisions have found that unless BCBSM reserves are excessive, BCBSM is not required to use reserves to subsidize one line of business over the others.

When would the new premiums go into effect?

We have asked that our new rates go into effect in October 2010 under the proposal. The state must approve our premiums prior to them taking effect.

Will I receive notice before any rate increase appears on my bill?

Yes. Subscribers will receive notification of a premium increase 30 days prior to the increase appearing on your bill.

Does the rate request affect Medigap products?

No. The request does not affect BCBSM Medicare Supplemental plans (Medigap) purchased by Medicare-eligible beneficiaries.

Does the rate request affect BCBSM health plans purchased by employers (group coverage)?

No. The request does not affect BCBSM health plans purchased by employers.

What is BCBSM doing to keep rates low?
Insurance premiums in the individual market are driven by medical costs. As the only health insurer in Michigan that guarantees coverage for people with pre-existing conditions, our medical costs are higher than they would be if other insurers would take responsibility for covering people who are more costly.

To control medical costs and improve health care for people, BCBSM works every day with doctors and hospitals to improve the quality of healthcare, eliminate medical errors and combat healthcare fraud. This report details our efforts working with doctors, hospitals and other health care providers.

Isn’t BCBSM tax-exempt?

BCBSM does not pay taxes to the state or local governments, but BCBSM does not profit from its tax exemption. An independent analysis of our tax exempt value and our regulatory requirements found that BCBSM returns at least $391 million – several times the value of its state tax exemption – to Michigan through contributions such as helping provide access to health care for children by supporting the MIChild program, providing discounts on Medigap plans for older adults, and through other contributions.

What other less costly product options can I consider and where can I get the information?

Even with anticipated rate increases, BCBSM individual products remain some of most affordable individual products in our state. You can click through this online tutorial that will help you pick a plan that is right for you. You can also view benefit and cost information for available products at bcbsm.com.

If you have any questions please contact us at newsroom@bcbsm.com

Andy Hetzel

Vice President, Corporate Communications, BCBSM

Imagine Having 250 Nurses at Your Fingertips – With BlueHealthConnection® You Can

2010-05-18T14:34:00.001-04:00

BlueHealthConnection is a collection of health management programs that give Blues members access to health education, support, and health and wellness resources to help them take charge of their health.

BlueHealthConnection offers several programs that are supported by licensed, registered nurse health coaches and case managers. These experienced professionals assist

members in their efforts to stay healthy, get healthier or manage illness. Available programs supported by registered nurse health coaches include:

· 24-hour nurse line  Answers members’ health care questions.

· Chronic condition and disease management  Helps members with chronic conditions manage their care.

· Case management  Helps members coordinate their care and provides education about their conditions.

· Quit the Nic – Works with members one-on-one to help them develop action plans to quit smoking.

BlueHealthConnection also connects members to a variety of online resources including:

· Online health coaching  A team of virtual experts give members personalized plans and supportive tips on how to live healthier lifestyles.

· Health assessment  An online questionnaire that helps members pinpoint specific health issues and risks, and guides them to healthy behaviors.

Blues members can easily access these online resources through Member Secured Service at bcbsm.com or MiBCN.com.

Michelle Fullerton, BCBSM director of BlueHealthConnecton - Wellnes and Care Management Operations, describes the benefits of the program best when she said, “The most exciting thing about BlueHealthConnection to me is the difference we make in members’ lives.”

Well said Michelle. To hear what other people are saying and join the discussion regarding ways to lead Michigan to a healthier future, visit ahealthiermichigan.org.

Hear Michelle talk more about BlueHealthConnection here:

Stay Out! Hospitals partner with Blues to lower readmissions

2010-05-17T10:55:00.001-04:00

This week, Blue Cross Blue Shield of Michigan announced 15 physician organizations and hospitals across the state that will be collaborating with the Blues to reduce the incidence of preventable ER visits and preventable readmissions to the hospital.

A preventable readmission is when a patient is readmitted to the hospital within 30 days of being discharged, for the same diagnosis or a complication of that diagnosis, which could have been prevented with proper care management and coordination.

Lowering the readmission rates will have a positive impact on thousands of Michigan lives. Not only will it improve safety, but it will save costs. In 2008, Blue Cross Blue Shield of Michigan spent $75 million on preventable readmissions – roughly $11,490 for each patient whose readmission could have been prevented.

This 15-site initiative is a long-term effort that will improve communication and coordination among hospital-based physicians and nurses and doctors in private practice. The participating hospitals and physician organizations will share their learnings with each other, in a collective effort to improve patient safety and clinical quality.

This kind of collaboration is the heart of what we call our Value Partnerships, a collection of initiatives that focus in improving health care quality and safety for Michigan residents. It’s how the Blues are working to lead Michigan to a healthier future.

National Nurses Week is here

2010-05-11T17:10:00.002-04:00

We celebrate National Nurses Week from May 6 through May 12. This is a time to honor those gracious health care professionals who are dedicated to the wellbeing of patients.

If you think National Nurses Week was created without any roadblocks, you are mistaken. In 1953, Dorothy Sutherland began fighting to have the government officially designate a day to honor nurses across the country. It wasn’t until almost 30 years later that President Reagan declared that May 6 would be “National Recognition Day for Nurses”. From there, the day was extended to a week.

If you talk to a friend, a neighbor or a family member, chances are they have a positive story to tell you about an experience they had with a nurse. At times when people are sick, stuck in a hospital bed, or in need of some health related guidance, nurses are there for support.

At the Michigan Blues, there are over 250 nurses that play an integral role within the company. Customers have direct access to nurses, dieticians, case managers and more via the Blue Health Connection program.

Terry Muse had an especially wonderful experience with a case manager at BCBSM. This story illustrates the added value of the Michigan Blues’ insurance.

So, think back this week about those nurses that have had a positive impact on your life and thank them again if you get a chance.

The Physician Group Incentive Program

2010-05-11T13:56:00.003-04:00

Blue Cross Blue Shield of Michigan spearheads a number of statewide initiatives focused on improving health care quality. Check out this brief update from our recent Physician Group Incentive Program conference in Lansing.

Blues build social media leadership as Shannon Paul joins our team

2010-05-10T12:01:00.001-04:00

Have you clicked your way to ahealthiermichigan.org lately? Or the walkytalk blog? Or our Facebook cause page for Michigan health care reform? Or our Twitter feed?

Or this?

Or even this blog? In a short time, Blue Cross Blue Shield of Michigan has certainly established our belief that interactive online communications channels hold value in this new era of communication. But anyone who knows “social media” will tell you that having a lot of channels doesn’t necessarily make you a leader. It’s how those channels support your overall business strategy and stakeholder needs.

Do they constitute a symphony, working in harmony to deliver information that delights the audience and tells a story? Or are they just more noise in a growing cacophony of clanging bells?

Leadership brands that use social media well have two things in common. They understand what their stakeholder audiences want and need – and they have leaders managing their social media channels who are the maestros of our new age of communications. Using tools and methods for interactive dialogue, social media leaders can stand and conduct a symphony that thoroughly engages and delights any organization’s audience.

We are pleased to have two such leaders conducting our social media efforts at Blue Cross Blue Shield of Michigan.

Jerome Espy came to us early in 2010 from Detroit Medical Center to be our director of External Affairs. At DMC, Jerome helped launch and manage a vast array of social media tools, and he rallied support from within the organization to align these new channels to support the organization’s brand positioning and its mission to provide top quality health care for people. Jerome’s accomplishments in his first three months at BCBSM include all of our new social media channels, including this blog and our new multimedia newsroom.

On June 7, joining Jerome will be Shannon Paul. She comes to BCBSM from far away Seattle as our new manager for Social Media. She’s a native Detroiter. Her return is a good story given Detroit’s lingering challenges with losing smart, young talent to other places… like Seattle. Shannon’s coming home, and bringing us a well-earned national reputation for her social media leadership. Her blog is listed in the Advertising Age Power 150, and is required reading in several university classrooms and used as a resource for articles in Information Week, The AtlanticWire, Web Worker Daily and Smart Brief on Social Media, among others. But it’s what she will do here in Detroit – for Blue Cross – that matters to you.

And there’s that word: “you.” You are what this is all about.

If the Michigan Blues are to establish true leadership in use of social media, our efforts will enable you to connect with us in ways that enhance your relationship with us, and that enhance your well being.

Our goal is to build and manage interactive channels that engage you in responsible, ethical and productive conversations. Jerome and Shannon – batons in hand – are prepared to conduct our social media symphony. You will be invited, very soon, to review their debut performances.

Andy Hetzel

Vice President, Corporate Communications

Blue Cross Blue Shield of Michigan surprises students with Matthew Stafford on ACES Day

2010-05-07T07:16:00.000-04:00

What were children across the world doing at 10:00 a.m. on Wednesday, May 5? Exercising! That’s because it was ACES (All Children Exercise Simultaneously) Day, a program that encourages students to exercise and engage in physical activity. And, Blue Cross Blue Shield of Michigan made ACES Day extra special for one school in Michigan.

Matthew Stafford poses with students during ACES Day.

Students at Martin Luther King, Jr. Academy in Mount Clemens were surprised when Matthew Stafford, quarterback of the Detroit Lions, showed up to exercise along with them. He spoke to the more than 300 students and staff about the importance of eating healthy and exercising. Six students had the chance to ask Stafford questions about his exercise and healthy eating habits, while six others got to participate in a HOPSports activity with him. Stafford then lead everyone in a walk around the school and spent time visiting with students at activity stations where he helped kids jump rope, threw football passes and challenged students to pull-up contests.

In 2009, Matthew Stafford and BCBSM announced their partnership to combat childhood obesity in Michigan through the promotion of preventive measures that foster healthy lifestyles. This partnership was truly witnessed at MLK Academy in Mount Clemens on ACES Day.

Stafford challenges student pull-up contest on Fitness Center funded by BCBSM grants.

Stafford talks to Michael Patrick Shiels of WJIM-AM, while Ken Dallafior looks on.

Blues poised to thrive, lead in a post-reform world

2010-05-06T21:28:00.000-04:00

Discussions of how to fix our country’s broken health care system have dominated political discourse over the past year. Now that national health care reform legislation has been signed into law, our work has not ended. In fact, as BCBSM President and CEO Dan Loepp said in a statement March 22, the passage of the legislation “is just the beginning.”

The Michigan Blues are well-positioned to operate in a post-reform world since we have been pursuing health care reform in myriad ways for the past several years. In fact, many of our initiatives could serve as a national model for continuing reform. Here are two examples:

Our patient-centered medical home program, the largest of its kind in the country, is placing renewed focus on the role of the primary care doctor. The primary care physician’s practice serves as a patient’s medical home, helping to coordinate every aspect of the patient’s care. One report showed that if every American had a medical home, it would result in savings of more than $100 billion per year and improved health care quality.
Our Collaborative Quality Initiatives bring together physician groups and hospitals across the state to analyze clinical data, share best practices and implement changes that improve health care quality and lower costs in such areas as angioplasty, surgery and oncology. These efforts have saved hundreds of millions of dollars and many lives.

A new booklet, the 2010 Partners in Health Care Report, takes an in-depth look at these initiatives, illustrating how Michigan could lead the nation in health care reform. Check it out and let us know what you think.

Free Clinics provide safety net to those most in need

2010-05-04T15:25:00.001-04:00

Any parent can share war stories about raising kids and multiple visits to doctors’ offices and emergency rooms over the years. It is almost like a “rite of passage” in the parenting arena.

There are always tales about broken arms, the stitches in the chin, the scary fall off the bed, plenty of upper respiratory infections to go ‘round, and more 24-hour stomach bugs than anyone cares to recollect. Being a Blues member is a blessing for that reason alone.

It’s comforting to know that you and your family can get the care they need when they need it - covered or not.

Which is why Michigan’s free clinics are so crucial. Across our great state, an estimated 1.8 million people go uninsured - and that number is anticipated to rise steadily until 2011. These clinics provide the safety net that residents without coverage or money to pay for care desperately need to stay healthy and manage chronic conditions like asthma, diabetes and high blood pressure.

So for six years and running, the Blues is helping to keep non-profit free clinics going through its Strengthen the Safety Net grant program. Clinics use this funding to expand their services, partner with their local hospital, improve their technology or make other enhancements.

Know of a free clinic in your area that could use some extra funds? Spread the word – encourage them to go to bcbsm.com/safetynet for more information on the Strengthen the Safety Net grant program.

Blue Cross Blue Shield of Michigan ahead of pack with long-standing policy regarding insurance rescissions

2010-04-29T22:27:00.001-04:00

Imagine planning to undergo surgery thinking you are well protected by your health insurance only to find out, just one day before you go under the knife, your coverage was dropped. That’s just what happened to a Dearborn man, and it’s a practice that needs to end here in Michigan now.

Blue Cross Blue Shield of Michigan never drops people from coverage when they become sick – a much-maligned practice called rescission – except in cases of fraud or intentional material misrepresentation.

This is yet another example of how the Blues stand as a model for health reform.