Insurance Commissioner issues report on BCBSM Hospital Provider Class Plan

July 19, 2012

DETROIT — The Michigan Insurance Commissioner issued a Determination Report regarding Blue Cross Blue Shield of Michigan’s Class Plan for hospitals for a two-year period covering 2009 and 2010. The report found that BCBSM met two of its three goals:

  • BCBSM met its goal for quality health care. The report said that BCBSM has continued its efforts toward promoting patient safety and delivering high quality care through quality management initiatives. It cited BCBSM programs including its Participating Hospital Agreement Pay-for-Performance program, the BCBSM Cardiovascular Consortium and Cardiac Centers of Excellence. BCBSM also has been an active participant in the Michigan Quality Improvement Consortium and the Michigan Health & Safety Coalition initiatives dealing with evidence-based practice and safety standards.
  • BCBSM met its goal for access to care. The report said it maintained a formal participation rate of 100 percent with Michigan acute care hospitals during the two-year period under review. BCBSM also instituted a variety of ways for hospital providers to keep informed about BCBSM programs and policies. 
  • BCBSM met its health care cost goal based on the statutory health care cost formula. But it did not fully meet its cost goal because the Commissioner determined that recognition should be given to government shortfalls sustained by the hospitals in Medicaid and Medicare.  

Within six months, BCBSM is required to submit an amended Provider Class plan to the Commissioner for review.

Blue Cross Blue Shield of Michigan is a nonprofit corporation and independent licensee of the Blue Cross and Blue Shield Association.