PO’s Adoption of BCBSM’s Blueprint for Affordability Reflects Value Of Trusted Partnerships
By EWA MATUSZWEWSKI
Amid the flurry of pandemic responses and mitigation initiatives that physician organizations added to their plates in 2020 was a separate event that had been under consideration since just before the pandemic. I’m referring to Blue Cross Blue Shield of Michigan’s Blueprint for Affordability program, which was launched in January 2020.
Designed to hold the line on healthcare costs as it enables improved care quality, coordination of care, and outcomes for patients, Blueprint for Affordability is a value-based compensation model where each physician organization partner has annual cost-of-care targets and clinical quality benchmarks to meet. The targets are tailored to each organization’s unique patient population. If an organization optimizes patient health to keep its overall cost below target and meets its quality performance metrics, it will receive additional financial rewards from Blue Cross. If quality metrics are not met, driving costs above target, the organization will rebate Blue Cross, and ultimately its customers, a portion of the overage.
Seven physician organizations signed on initially, but I’ll admit our organization wasn’t completely on board at the outset. Frankly, it was a risky venture and our leadership team wanted to make sure we were well positioned to enter into this partnership. That being said, we are not a risk-averse organization. We got our start as a PO 40 years ago this year, serving as an association of sorts for “homeless” independent, self-employed primary care physicians who were not as savvy on the business side of the healthcare system. They knew how to practice medicine but didn’t necessarily understand how to negotiate with payors or maximize benefits gained from economies of scale. Thankfully, they trusted us, and that trust has resulted in our nearly 1,000 physician and other provider members.
Trust is a word that’s sometimes bandied about without the currency to support it. But Michigan wouldn’t have such a strong and innovative healthcare community were it not for the trust that binds us together. The Blueprint for Affordability is an example. Of course, the adage to “trust, but verify,” is wise counsel. We did that and overcame our original concerns and now are happy to be a part of a program that includes a total of 21 Michigan physician organizations who trust that the move from traditional fee for service to value-based care is the best approach.
Our chief medical officer, Dr. Al Juocys, took the occasion of this new partnership to reflect back to an earlier agreement with Blue Care Network, originally known as Healthcare Network, that was considered transformational. I quote him here: “When we signed our first managed care agreement with Healthcare Network, more than 30 years ago, we sought a better path for patient care reimbursement. Now, with the Blueprint for Affordability, we enter a new level of partnership with BCBSM and look forward to working collaboratively on Blueprint activities that are hyper-targeted to improve the delivery and quality of healthcare outcomes for patients, resulting in more affordable care.” The word trust wasn’t mentioned -but it was understood.
Throughout the pandemic, the global healthcare community has relied on each other as never before. We have turned to Johns Hopkins, the CDC and international organizations including WHO and NHS – old and new trusted sources – to establish protocols for patient care. We have turned to pharmaceutical giants and even a few heretofore unknown pharma partners -to create a trusted vaccine in record time. Now we must trust that vaccine administration will be consistently swift, fair, and safe – and do our part to ensure that it is.
At the risk of sounding sentimental, I want to thank all of those who have trusted in MedNetOne for the past 4o years: from our members, to BCBSM and other payors, to our physician organization colleagues, especially the independent physician organizations and community organizations with whom we have partnered or collaborated. In a new year still filled with uncertainty, we take comfort in the knowledge that trusted relationships will again see us through. Ad multos annos!