Over a five-year period, five programs sponsored by Blue Cross Blue Shield of Michigan and Blue Care Network to improve the quality of certain medical and surgical procedures performed in Michigan hospitals, have produced $597 million in healthcare cost savings, and have lowered complication and mortality rates for thousands of patients.
The results of these five Collaborative Quality Initiatives – covering general surgery, bariatric surgery, angioplasty, vascular conditions and cardiac surgery – were achieved through widespread collaboration among Blue Cross and 75 Michigan hospitals.
An actuarial analysis found the program savings resulted from avoided costs, specifically complication reductions; and prevention of erroneous and unnecessary procedures. The analysis indicates about 30 percent of the program savings were attributed to Blue Cross or Blue Care Network patient procedures, while about 70 percent was attributed to patients with Medicare, Medicaid, self-insured plans, other private plans or no insurance.
"These initiatives are rapidly improving the healthcare environment across the state, and have positioned Michigan as a national leader in transforming health care through collaboration among hospitals, physicians, health professionals and insurers," said Daniel J. Loepp, BCBSM president and CEO in a statement. "This model enables competitors to work together as partners in large-scale efforts that reduce complications, improve patient outcomes, and significantly decrease unnecessary healthcare costs."
2008 – 2012 cost savings for the five programs studied broke down as follows:
Michigan Surgical Quality Collaborative (general surgery): $230.3 million statewide savings; $106.2 million BCBSM savings; Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative (cardiac and thoracic surgery): $78.2 million statewide savings; $5.7 million BCBSM savings; BCBSM Cardiovascular Consortium (angioplasty and vascular interventions combined): $260.9 million statewide savings; $30.8 million BCBSM savings; Michigan Bariatric Surgery Collaborative (bariatric surgery): $27.8 million statewide savings; $9.3 million BCBSM savings."While the dollar savings are important, it's crucial to see the meaning behind the money. These CQIs are saving and improving lives. The cost savings come because people are coming home from the hospital sooner, and healing without complications so they can return to work on time," said David Share, MD, BCBSM senior vice president of Value Partnerships, in a statement.
Across Michigan, 75 large and medium size acute care hospitals participate in at least one CQI, and collectively, the 15 hospital-based CQIs analyze the care given to over 200,000 Michigan patients annually. Each CQI uses a coordinating center to collect and analyze the data.
The University of Michigan Health System serves as the coordinating center for 14 CQIs, and Henry Ford Health System serves as the coordinating center for one. Participating physicians and health professionals review the data and share experiences to develop best practices and new processes that reduce errors, prevent complications and improve patient outcomes.
"There are no other quality improvement initiatives structured like these Collaborative Quality Initiatives, and the unique structure works. Because there's a strong environment of cooperation among these statewide consortiums, and because participants are encouraged to work with their colleagues on issues they deem important, participants are highly engaged and able to make fast progress," said Jack Billi, MD, University of Michigan Health System.
In addition to the five CQIs noted for cost savings, there are ten other CQIs focusing on blood clot prevention, blood clot management, breast cancer, trauma center quality, operating room safety, hip and knee replacement, spine surgery, anesthesia, surgical episodes of care and radiation treatment for cancer.