BCBSM-Munson Contract Embraces Value-Based Reimbursement Approach

Munson Healthcare and Blue Cross Blue Shield of Michigan (BCBSM) are launching a new value-based hospital reimbursement agreement in northern Michigan designed to improve patient care and medical outcomes while also enhancing efficiency and holding down the cost of care.

The new reimbursement arrangement covers a three-year period and supports closer collaboration between the hospitals — Munson Medical Center in Traverse City, Kalkaska Memorial Health Center in Kalkaska, and Paul Oliver Memorial Hospital in Frankfort — and their physician partners to improve the health of the populations they serve. To accomplish this, BCBSM will provide the health system with funding for infrastructure improvements needed to better coordinate care between the hospitals and physicians.

Since last year all three hospitals have been working with their provider partners in the community to develop and implement an infrastructure plan that includes an all-patient registry system. The system would enable caregivers in the hospital and in doctor’s offices to have easier access to patients’ records so that information can be combined from multiple sources to promote coordination of care, improve care quality, and help ensure the right care is given at the right time in the right setting.

Their agreement provides a fair base-rate increase in reimbursement from BCBSM to the hospital. In addition Blue Cross will reward the hospitals with a share of the savings achieved when hospitals and physicians coordinate the delivery of efficient and effective care, eliminate reuse and over use of care, and prevent re-hospitalizations.

On the federal level, evolving from the traditional fee-for-service payment approach toward more emphasis on value-based hospital contracting has already shown success.

Each hospital and its physicians have established milestones to ensure infrastructure work continues along with funding through 2015.

Source: Blue Cross Blue Shield of Michigan (BCBSM) , November 12, 2013


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