Affordable health care isn’t something any single company, provider or policymaker can achieve alone. It requires partnerships — across health systems, providers, insurers, regulators and pharmaceutical companies — to address the root causes of rising costs.
At Blue Cross Blue Shield of Michigan, we stand for partnering with those who share our commitment to affordability, ensuring that we all can have access to affordable health care.
Why Partnership Matters for Affordability
Health care costs are rising due to multiple factors — high drug prices, outdated payment models and increasing demand for services because of an unhealthy and aging population. The only way to fix this is to work together.
How We’re Partnering for Affordability
Value-Based Care that Saves Billions
For nearly two decades, our internationally recognized Value Partnerships program has been transforming the way care is delivered in Michigan. Instead of paying providers based on the number of tests or procedures performed — some of which aren’t needed or don’t work—we reward providers for improving quality, efficiency and better health outcomes.
- We achieved $6.3 billion in avoided costs since 2005 by reducing unnecessary procedures and hospitalizations. This is money that would have otherwise flowed into your health insurance costs.
- More than 20,000 physicians and 100 hospitals participate — creating a model of partnership that is nationally and internationally recognized.
- Our Patient-Centered Medical Home (PCMH) program has transformed primary care and led to fewer emergency room visits and better chronic disease management for our members.
By working directly with doctors and hospitals, we’re improving care while lowering costs.
Blueprint for Affordability
Prices for medical care are one of the largest upstream drivers of health insurance costs. Through our Blueprint for Affordability program, we’re working in partnership with Michigan’s leading hospital systems and physician organizations to improve patient outcomes while reducing inefficiencies.
- One million members are covered under the program.
- $93 million in health care savings has been achieved in just three years, preventing those costs from pressuring your health insurance premiums.
- Hospitals, physician organizations and Blue Cross all share financial responsibility for the quality care and patient outcomes we collectively seek. Currently, 25% of our providers are in full-risk arrangements, which means they are financially accountable for the cost and quality of care they provide.
When hospitals, providers and insurers work together, patients receive higher-value care at a lower cost. We need more hospitals and providers to move to value-based care.
Prescription Drug Prices
The skyrocketing price of prescription drugs is one of the biggest affordability challenges in health care. We’re advocating for regulation of prescription drug pricing and investing in lower-cost alternatives to reduce these expenses.
- Leading the push for biosimilars — 90% of our members using Remicade have switched to biosimilars, saving millions.
- Partnering with a nonprofit, Civica Rx, to produce low-cost generic medications.
- Negotiating to keep drug price increases in check for our members.
- Supporting lowering the monopolies our U.S. Patent law gives to drug makers– getting competition to market faster and lowering prices.
- Regulating prescription drug pricing, just like they do hospitals and insurers.
We also work closely with Michigan’s Department of Insurance and Financial Services (DIFS) to ensure fair and transparent premium pricing for our members.
Expanding Access Through Community Partnerships
Affordability isn’t just about reducing costs — it’s about ensuring people have access to the care they need, when and where they need it. That’s why we’re investing in rural health partnerships, community health programs and employer collaborations to expand access:
- Rural health partnerships with Homeward provide in-home and virtual care to 65,000 eligible Medicare Advantage members in underserved Michigan counties.
- Employer partnerships help businesses manage health care costs while keeping employees covered.
- Community health grants support local initiatives to improve preventive care access and reduce high-cost interventions.
Partnerships Are the Key to Affordability
The health care system is too complex for any one group to solve affordability alone. That’s why Blue Cross Blue Shield of Michigan is committed to expanding and building partnerships that deliver affordable, accessible health care. By standing for partnership, we’re ensuring that affordable, high-quality health care and health insurance isn’t just something we talk about — it’s something we all work together to achieve.
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