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Payment model prioritizes quality and coordination of care

Media Contact: Barbara Fornasiero, EAFocus Communications; 248.260.8466; barbara@eafocus.com

Rochester, Mich. – December 11, 2020 –MedNetOne Health Solutions (MedNetOne), a healthcare management organization offering infrastructure, clinical, and technology services to nearly 1,000 private practice physicians and other independent care providers including behavioral health specialists, is pleased to announce it has joined physician organizations across the state in partnering with Blue Cross Blue Shield of Michigan’s (BCBSM) Blueprint for Affordability program.

Blueprint for Affordability is a value-based payment model initially launched by BCBSM in January 2020. Now comprised of 21 physician organizations, it aims to hold the line on health care costs as it facilitates improved care quality, coordination, and outcomes for patients. With this model, each physician organization partner has annual cost-of-care targets and clinical quality benchmarks to meet. The targets are tailored to each organization’s unique patient population. If an organization optimizes patient health to keep its overall cost below target and meets its quality performance metrics, it will receive additional financial rewards from Blue Cross. If quality metrics are not met, driving costs above target, the organization will rebate Blue Cross, and ultimately its customers, a portion of the overage.

The Medical Network One physician community is no stranger to transformational change, according to President and Chief Medical Officer Al Juocys, DO., and welcomes another opportunity to collaborate in a forward- thinking payment model that also addresses patient needs.  

“When we signed our first managed care agreement with BCBSM more than 30 years ago, we sought a better path for patient care reimbursement. Now, with the Blueprint for Affordability, we enter a new level of partnership with BCBSM and look forward to working collaboratively on Blueprint activities that are hyper-targeted to improve the delivery and quality of health care outcomes for patients, resulting in more affordable care.”

Including MedNetOne and the 20 other physician organization partners, the Blueprint for Affordability payment model represents roughly 38% of BCBSM’s total Commercial PPO membership and 42% of the Medicare Advantage PPO membership.

“Patients want and deserve high-quality care.  Their employers want costs that are more predictable and manageable,” said Blue Cross Blue Shield of Michigan President and CEO Daniel J. Loepp. “Participating organizations are willing to put a portion of their reimbursement on the line, as they work toward more predictable costs and improved health care quality and efficiency for their patients.”   

Blue Cross and provider partners have been pioneering the shift to value-based care in Michigan since 2005. Through more than 50 Value Partnerships initiatives, including the nation’s leading Patient-Centered Medical Home program, Blue Cross saved $2.2 billion in medical costs. This has translated to nine premium reductions for small group customers over the past four years and moderation of rates in the individual and Medicare Advantage markets. For more information, visit BlueprintForAffordability.com.  

About Blue Cross Blue Shield of Michigan

Blue Cross Blue Shield of Michigan, a nonprofit mutual insurance company, is an independent licensee of the Blue Cross and Blue Shield Association. Blue Cross provides and administers health benefits to more than 4.7 million members residing in Michigan in addition to employees of Michigan-headquartered companies who reside outside the state. The company has been committed to delivering affordable health care products through a broad variety of plans for businesses, individuals, and seniors for 80 years. For more information, visit bcbsm.com and MiBluesPerspectives.com.

About MedNetOne Health Solutions

Based in Rochester, Mich., MedNetOne Health Solutions is a leader in advancing the development and implementation of the Patient-Centered Medical Home (PCMH) and advanced primary care. Its physician/provider members are focused on fully integrated, population-based, patient-centric practices that enhance patient outcomes and meet government healthcare reform mandates. Learn more here.