Blue Cross Blue Shield of Michigan Looking to Improve Operating Results in 2022

Blue Cross Blue Shield of Michigan (BCBSM) recently reported net income of $360 million for 2021 despite an operating loss of $374 million largely for its health insurance business due to the ongoing costs of the COVID-19 pandemic.

The net income, about 1% of the insurer’s $32.5 billion in revenue, was a result of strong gains in its investment portfolio and profits from non-health lines of insurance business.

BCBSM provides health benefits to more than 4.7 million members residing in Michigan in addition to employees of Michigan-headquartered companies residing outside the state.

BCBSM announced a joint venture with  Honest Medical Group to offer physicians comprehensive operational, clinical, and financial support for shared accountability Medicare contracts. The joint venture is the first of its kind for BCBSM and aligns with the organization’s continued expansion of Blueprint for Affordability, its member-focused, value-based care and payment models.

Physician organizations can choose to work with Honest Medical Group for support in making administrative and operational changes needed to be successful in full financial-accountability Traditional Medicare and Medicare Advantage agreements with payers.

Honest Medical Group was created specifically to improve the care experience and reduce costs for people with Medicare. The new partnership will transform the way care is delivered for a physician’s whole Medicare patient panel, permitting physicians to use Honest Medical Group for its Traditional Medicare and Medicare Advantage members in any health plan.

Blue Care Network (BCN) has launched a precision medicine program called Blue Cross Personalized Medicine that will use pharmacogenomics to personalize and tailor medication treatments for members.

BCN will base the treatments on a review of members’ prescribed medications for diagnoses, including behavioral health, cardiology, cardiovascular and oncology.

A pilot program is underway for some members through the end of 2022, with a full program launch scheduled for January 2023 for eligible Blue Care Network members with pharmacy benefits. The genetic testing program will be free to members and employers.

OneOme, a Minneapolis-based biotechnology company, will facilitate the new program. The company will provide pharmacogenomic testing and reporting and analytics through its “RightMed for Populations” program.

BCN, a HMO owned by BCBSM, is the state’s largest HMO with more than 840,000 members.

Takeaway: BCBSM is leading transformative change in developing and facilitating value-based care arrangements in Michigan while ensuring physicians can be successful in these arrangements

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