In brief: Select 1 PO with affiliated medical care group; U.S. News & World Report recognition; updates to practitioner fees; Oncology Value Management program

Reminder: Select 1 PO with affiliated medical care group to support all Blue Cross, BCN business

Before Jan. 1, 2026, each primary care provider must align with one physician organization and that PO’s affiliated medical care group. It’s important for primary care providers to receive support for all Blue Cross Blue Shield of Michigan and Blue Care Network lines of business in which they choose to participate.

This includes our commercial and Medicare Advantage plans.

Read the full article in the March 2025 Record.

Blue Cross named top-performing 2025 Medicare Advantage plan by U.S. News & World Report

U.S. News & World Report named Blue Cross Blue Shield of Michigan as a top-performing Medicare Advantage plan in Michigan, and one of only four companies in the country to earn recognition as 2025 Best Overall Medicare Advantage Company.

In addition to this top honor, according to U.S. News & World Report methodology, Blue Cross shared the top score of 4.2 out of 5 stars with only one other plan.

U.S. News & World Report used the Centers of Medicare & Medicaid data and consulted Medicare experts to identify and weigh quality measures they thought were most important to consumers, including the best value, highest-quality care and an appealing set of benefits at an affordable price.

To learn more, read the article “U.S. News Announces the 2025 Best Insurance Companies for Medicare Advantage.”*

Blue Cross updates to practitioner fees will take effect July 1

Blue Cross Blue Shield of Michigan will change practitioner fees for services provided on or after July 1, 2025. This change applies to services provided to our Traditional, TRUST and Blue Preferred PlusSM members, regardless of the customer group.

Blue Cross will use the 2025 Medicare resource-based relative value scale for most relative value unit priced procedures for dates of service on and after July 1. Most fees are currently priced using the 2024 values.

For complete details, see the April 2025 Record article.

Announcing changes to management of oncology medical benefit drugs

We’re adding more oncology medical benefit drugs given by health care providers to our Oncology Value Management program administered by OncoHealth. Starting June 1, health care providers should submit prior authorization requests to OncoHealth for the drugs listed in the April 2025 Record article.

Changes to Oncology Value Management program will start April 1

As we previously announced, starting April 1, 2025, oncology pharmacy benefit drugs will be managed through our Oncology Value Management program. Starting April 1, health care providers can submit prior authorization requests for these drugs to OncoHealth, which administers the Oncology Value Management program.
To learn more, see the April 2025 Record article.

*Blue Cross Blue Shield of Michigan and Blue Care Network don’t own or control this website.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.