BCBS of Michigan adds 7 providers to risk-based payment program

Another seven healthcare organizations agreed to share financial risk with Blue Cross Blue Shield of Michigan under a value-based payment initiative called the “Blueprint for Affordability,” the insurer said Dec. 9.

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The model, which debuted in December 2019 with seven provider partners including Ascension Michigan in Warren and Henry Ford Health System in Detroit, will now include 21 providers. 

Here are the seven Michigan organizations that most recently joined. View a full list of the organizations here

  • Accountable Healthcare Advantage (Ann Arbor)
  • Beaumont ACO (Southfield)
  • Medical Network One (Rochester) 
  • Oakland Physician Network Services (Sylvan Lake)
  • Primary Care Partners, in collaboration with Covenant HealthCare Partners (Saginaw) 
  • Professional Medical Corp. (Flint) 
  • Answer Health (Grand Rapids) 

Blueprint for Affordability sets annual cost and clinical quality targets for the providers. If providers stay below the cost target and meet quality metrics, they will receive additional payment from BCBS. Alternatively, if metrics are missed, providers may have to pay BCBS the amount that was overspent.

The 21 organizations in the model represent about 38 percent of BCBS of Michigan’s commercial PPO membership and 42 percent of its Medicare Advantage PPO members.

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