2023 Annual Report: Adapting to Meet the Whole Person Health Needs of Our Members and Customers
Blues Perspectives
| 4 min read
“Whole person health.” We use it today to describe health care that transcends beyond just the treatment of a person’s physical wellbeing. Blue Cross Blue Shield of Michigan is continuing to evolve our approach to treat the body, mind and spirit of our members and customers. That’s whole person health.
From advancements in precision medicine to an increased focus on supporting family health to more convenient avenues of digital support, BCBSM continued to adapt our model of care to make the patient experience more expansive, yet more intuitive in 2023.
Bolstered behavioral health services
BCBSM growth of behavioral health care services offer the support members need to think and feel better.
Through our partnership with Quartet Health, members can take advantage of virtual care navigation solution at no additional cost. An individual assessment matches you with an appropriate outpatient provider based on clinical needs and preferences, including the provider’s specialty, location and availability.
No longer does the emergency room have to be the go-to source to resolve a behavioral health crisis. The Medicare population can access prompt and appropriate behavioral mental health treatment through services like psychiatric urgent care, emergency mobile mental health assessments and a 24/7 recovery-oriented crisis center at participating facilities.
Family building and women’s health support through the Maven Clinic
Blue Cross expanded a partnership with Maven Clinic to help address issues faced by expectant parents and women experiencing menopause. The Maven Clinic offers high-quality, evidenced-based information and professional expertise to women for family building and women’s health through pre-conception, maternity, return to work, parenting, and menopause.
The Maven app and web-based support solution match you with a real-life care advocate that can help users better manage their health journey and allows you to join classes led by health care providers on a variety of topics.
A new comprehensive cancer support program
Cancer Support through OncoHealth’s virtual platform, Iris, ensures immediate virtual access to education resources, clinical oncology expertise, mental health support and a network of peer mentors for members with a cancer diagnosis as well as their caregivers.
Cancer Support features include but aren’t limited to:
- 24/7 access to US-based oncology nurses via chat, phone or video to ask questions related to symptoms and side effects and get immediate guidance and support.
- Mental health appointments with licensed therapists who specialize in working with members and families dealing with cancer.
- Oncology nutrition support from registered dietitians and nutritionists.
Helping members pay less at the pharmacy
Numerous breakthrough programs launched in 2023 to help members save on out-of-pocket pharmacy costs.
Our high-cost drug discount program helps members take advantage of manufacturer copayment assistance programs that significantly lower their out-of-pocket costs for more than 300 high-cost medications through the high-cost drug discount optimization program powered by PillarRx.
Members can receive discounts when they refill their medications regularly as prescribed with the drug adherence discount program powered by Sempre Health.
Like coupon or travel apps that search and find the best deals, Price Edge scans and compares direct-to-consumer pricing with insurance pricing to give the best available price to members on select non-specialty, generic drugs.
Read more about these efforts and other cost-cutting programs here.
More exceptional care options for seniors
Meijer entered the health insurance space for the first time in 2023, through our innovative partnership of the Medicare Plus Blue PPO + Meijer plan for seniors. It’s a partnership that allows Meijer to offer even more health benefits to shoppers. The plan’s benefits include:
- $0 monthly premium
- $0 annual deductible
- $0 primary care visits
- $0 copay on many generic prescription drugs
- A $660 in-store-allowance
Improving the prior authorization process
Prior authorization is a process that validates medical necessity and the appropriateness of services and prescriptions. BCBSM further reformed its process to relax approximately 20% of prior authorization requirements to improve health care quality, experience, access and affordability for members, while also reducing administrative tasks for clinicians.
We also expanded our “gold carding” program, which streamlines prior authorization for physicians who have a proven track record of making appropriate evidence-based decisions by exempting them from third-party prior authorization approval processes.
Precision medicine for personalized care
The Blue Care Network partnered with OneOme, a precision medicine company co-founded by the Mayo Clinic, to facilitate Michigan’s first end-to-end precision medicine pharmocogenomics program – Blue Cross Personalized Medicine.
Using OneOme’s RightMed Test, providers can use a patient’s genetic test results to help find the right medication for them. The Blue Cross Personalized Medicine program will be provided at no additional cost to eligible members or employer group customers.
