The Metro Detroit HMO network gives members in the Detroit area a lower cost health plan option with excellent geographic coverage. This is based on significant savings from working with a select group of physicians and hospitals.
Members who live in Wayne, Oakland and Macomb counties can choose this plan. All Metro Detroit HMO network providers are also located in these counties.
Doctors and hospitals in the Metro Detroit HMO network are also part of our statewide Preferred network. Metro Detroit HMO providers must meet additional requirements to take part in this value network.
Physician organizations that are part of the Metro Detroit HMO network commit to:
- Provide medical care within a fixed financial target
- Meet or exceed accepted clinical quality standards, for example, mammograms and childhood immunizations
- Make sure all members within the plan’s service area have access to providers
Participating physician organizations then pick primary care physicians from their organization based on this commitment to cost, quality of care and location.
The choice of specialist physicians is based on the long-standing referral patterns of primary care physicians in the physician organizations. These referral patterns are based on factors specific to specialists, including but not limited to:
- The quality of care provided to patients
- The appropriate use of medical resources such as tests and other treatments
- Employment relationship
- Care coordination
- Communication skills
Hospitals in the Metro Detroit HMO network were selected because they agreed to lower their rates on certain BCBSM products and work with the selected physician organizations.
Ancillary providers are selected by the physician organization, participating health systems and Blue Care Network. Ancillary providers include ambulatory surgery, physical therapy, home health, optometry, etc. If these providers are part of a health system not listed in this plan’s network, they may be excluded from the plan.
Members who have this plan can see Blue Care Network providers outside of the Metro Detroit HMO network with a referral from their primary care physician. Some services may also require authorization from Blue Care Network.
Hospitals in the Metro Detroit HMO include:
- Beaumont Hospital –Dearborn (formerly Oakwood Hospital)
- Beaumont Hospital - Farmington Hills (formerly Botsford Hospital)
- Beaumont Hospital – Taylor (formerly Oakwood Heritage Hospital)
- Beaumont Hospital – Trenton (formerly Oakwood Southshore Hospital)
- Beaumont Hospital – Wayne (formerly Oakwood Annapolis Hospital)
- DMC Detroit Receiving Hospital
- DMC Harper University Hospital
- DMC Huron Valley-Sinai Hospital
- DMC Hutzel Women’s Hospital
- DMC Rehabilitation Institute of Michigan
- DMC Sinai Grace Hospital
- Providence Hospital Southfield
- Providence Park Hospital – Novi
- St John Hospital & Medical Center – Detroit
- St John Macomb – Oakland Hospital – Macomb Center
- St John Macomb – Oakland Hospital – Oakland Center
- St John River District Hospital – East China
- St Joseph Mercy Hospital – Ann Arbor
- St Joseph Mercy Livingston Hospital
- St Mary Mercy Livonia Hospital