Facility input requested on SecureCare Network Performance Program implementation

Blue Cross Blue Shield of Michigan proposes that the SecureCare Network Performance Management Program be implemented April 1, 2022, for Blue Cross’ commercial and Medicare Plus Blue℠ members.

This would replace:

• eviCore, which currently provides tiering for therapy providers for Blue Cross and conducts tiering and prior authorization for Medicare Plus Blue therapy providers
• Optum, which provides tiering for Blue Cross commercial chiropractors

Physical therapists, occupational therapists, speech therapists and chiropractors will be asked to join the SecureCare network. There would be an annual cost to providers estimated at 2% of their Blue Cross commercial claims to join the network. (There’s no additional cost for Medicare Plus Blue claims.)

SecureCare allows for these provider types to treat patients without prior authorization or a treatment plan.

Other benefits include:

• Reduced administrative costs
• Support from the American Physical Therapy Association of Michigan and Michigan Association of Chiropractors
• Additional performance metrics
• Episodes of care included in reporting
• An opportunity to work with Blue Cross to determine performance thresholds for outliers
• Educational outreach to all outlier providers (The current program only provides educational assistance upon provider request.)

Note: Blue Care Network and BCN Advantage℠ will continue using eviCore.

Input requested

According to the Contract Administration Process — part of the Participating Hospital Agreement that went into effect July 1, 2021 — we allow non-binding input from participating hospitals about such proposals.

Input from facilities is requested by Nov. 30, 2021. Send any input you may have to Liz Bowman at ebowman@bcbsm.com.

After input is received, Blue Cross has 30 calendar days to respond to input.