Blues to share population health data with hospitals under value-based contracts

To support Blue Cross Blue Shield of Michigan’s value-based hospital contracting approach, the Blues will be sharing population health data with hospitals that have signed value-based contracts. These contracts hold hospitals accountable for a patient population in which hospitals and physicians share responsibility.

The data will include claims on all BCBSM commercial members who are attributed to the hospital’s partner physician organizations. These organizations meet established thresholds defined in the Population Insights report and have signed a letter of intent agreeing to partner with the hospital on population health management. 
                                                     
Additionally, the Blues may also provide hospitals with a list of the individual physicians within the physician organizations that meet these partnership criteria. All information shared with hospitals will be solely for the purpose of encouraging collaboration among providers to improve clinical integration, care management and care coordination across the care continuum. The end goal is to improve outcomes at an individual and population level.

About the value-based approach
BCBSM’s new approach to hospital reimbursement steers contracting from the traditional fee-for-service model to a population-based, fee-for-value approach. This approach rewards outcomes and encourages clinical integration and close collaboration between physicians and hospitals, helping spur the development of highly functioning health care systems.

BCBSM’s value-based hospital contract approach is part of a three-year reimbursement arrangement. It serves as the next step in aligning hospital and physician-directed incentives as we continue to move toward highly effective organized systems of care.

For more information about BCBSM’s value-based approach, please contact us at valuecontracts@bcbsm.com.