Value-Based Care

These national and local programs reward doctors for stronger care outcomes. Providing data to the doctors results in a better quality of care and lower costs for both you and your employees.

Why value-based care matters

1.
Improved overall health and well-being
2.
Higher-quality doctor and hospital care
3.
Better care coordination and access
4.
Reduced costs for business and employees

How these programs work

When doctors and hospitals are rewarded for better outcomes, both you and your employees benefit. Your employees can choose from more than 20,000 doctors who have partnered with Blue Cross to provide high-value care. Promoting illness prevention and wellness programs can mean fewer trips to the ER for your employees and reduced costs for you. 

Total Care

Total Care doctors and hospitals focus on overall health, well-being and prevention. They provide care that's coordinated with the patient's other providers. 

Doctors with the Total Care designation aim to: 

  • Help your employees make better decisions about their health
  • Encourage prevention and wellness programs
  • Make health care more accessible and flexible 

Blueprint for Affordability

Blueprint for Affordability is an agreement between providers and Blue Cross. These providers make a commitment to improve quality and lower costs. They coordinate their quality of care and patient outcomes to meet cost-savings goals.

  • Unnecessary ER visits
  • Repeated testing and hospital trips
  • Complications and errors

Patient-Centered Medical Home

Patient-Centered Medical Home is our Michigan designation for high quality, value-based primary care. These primary care practices are delivering better results and reducing unnecessary spending, while showing higher incidences of preventive screenings. This program includes 4,692 physicians across 1,709 practices, serving 1.2 million members.​

Physician Group Incentive Program

This program consists of more than 20,000 primary care and specialist physicians in Michigan involved in quality improvement efforts. It connects 40 physician organizations focused on improving the health care system in Michigan. This is accomplished through collaboration, sharing of best practices and data collection to increase the overall value of care while reducing costs.

Centers of Excellence

We also address cost and quality with our national Blue Distinction Specialty Care program. It recognizes hospitals and health care facilities that deliver consistent, quality care in certain specialties that have high-impact costs, including:

  • Bariatric surgery
  • Cardiac care
  • Maternity care
  • Spinal surgery
  • Oncology care
  • Transplants
  • Knee and hip replacement
  • Fertility care
  • Gene therapy – ocular disorders
  • Cellular immunotherapy – CAR-T
  • Substance use treatment and recovery

Across all these programs, savings are shared between providers and health systems and help make health care more affordable for your employees.

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