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BLUES, HENRY FORD AND MERCY ANNOUNCE NEW COMMUNITY CARE PARTNERSHIP

 DETROIT, Feb. 15 /PRNewswire/ -- Blue Cross and Blue Shield of Michigan, Henry Ford Health System and Mercy Health Services have announced a regional health care benefit delivery arrangement that can limit premium rate increases to 5 percent a year for at least the next two years for large group customers, which is significantly below current health care cost trends.
 Called "a community care partnership" by the sponsors, the new arrangement contractually links the Blues with its health maintenance organization (HMO) subsidiary Blue Care Network of Southeast Michigan, which in turn contracts for health care delivery primarily through a network of hospitals and physicians from Henry Ford Health System and Mercy Health Services.
 Formation of the new arrangement was announced jointly today by Richard E. Whitmer, president and chief executive officer (CEO) of Blue Cross and Blue Shield of Michigan; Edward Connors, president emeritus of Mercy Health Services; and Gail L. Warden, president and CEO of Henry Ford Health System.
 The broad-based arrangement can offer major employers a wide variety of Blues managed care products while meeting national demands for more accountable health care systems. It answers local and national demands for new ways to:
 -- Control cost and offer predictability of premium increases
 -- Provide broad access to a full range of high quality acute and
 tertiary health care services
 "This agreement is on the cutting edge of the national health care policy debate," said Whitmer. "It encourages expanded, more intense price competition by challenging others to match this new method for delivering health care benefits."
 Saying he was "encouraged because participation in an expanded provider network reinforces our commitment to a community health care system, and makes our services more accessible to the general public," Connors hailed the agreement.
 Warden said the network is "a good example of collaboration among health systems, providers, insurers and health purchasers which will improve quality and reduce cost. That's what our customers want. And that's what we must provide."
 Whitmer said the national health care debate has made it clear that we cannot continue business as usual with patchwork adjustments to existing health care plans.
 "We must break the gridlock and slow down the increases in costs and use of health care services," Whitmer said.
 The new agreement will be monitored closely to match the number of providers with the size of enrollment and access needs of the population served. Other centers of health care excellence will have a role in the community care partnership as the need develops, Whitmer said.
 The community care partnership includes elements of national health care policy proposals made by both major parties in the recent election, including:
 -- Encouraging greater use of primary care physicians
 -- Encouraging greater use of preventive medicine
 -- Creating a vehicle to set health care expenditure targets
 The new network built around Blue Care Network of Southeast Michigan and the core system of Henry Ford Health System and Mercy Health Services, which already have a joint venture in Southeast Michigan, will control premium increases to committed levels over multiple-year contracts through risk sharing and a limited network coupled with geographic access criteria.
 Under the premium-increase limit, core systems will be paid a fixed fee for each employee and dependent in the program. In turn, they will make certain that all needed health care services are provided no matter how severe the illness.
 This risk-sharing arrangement will join providers of care with the Blues and their customers not only financially but also clinically, and improve efficiency and accountability.
 It will restrain administrative costs by allowing utilization control, medical necessity determination and quality assurance decisions to be made by the Henry Ford and Mercy core system for many of the health care services.
 The network will encourage a new relationship between patients and primary care physicians such as general practitioners, internists and pediatricians, who will coordinate the care for their patients, even when they are being treated by outside specialists.
 These physicians will become the primary care managers in the new system and will be responsible for continuity of care and preventive medicine.
 The community care partnership is viewed as an umbrella network for new product offerings. It will not interfere with current preferred provider organization (PPO) and health maintenance organization (HMO) programs offered by the Blues, Blue Care Network of Southeast Michigan, Henry Ford and Mercy.
 The Blues operate a PPO, called Blue Preferred Care, in addition to the Blue Care Network of four HMOs across the state. Henry Ford operates an HMO called Health Alliance Plan and a PPO called Preferred Health Plan. Mercy operates an HMO called Care Choices, and a PPO called Preferred Choices.
 The Blues are expected to begin marketing new benefit plans under the community care partnership later this year.
 -0- 2/15/93
 /CONTACT: Rude Difazio of Blue Cross and Blue Shield of Michigan, 313-225-8113; Joanne Podlucky of Mercy Health Services, 313-489-6035; or Rich Swenson of Henry Ford Health System, 313-874-4086/


CO: Blue Cross and Blue Shield of Michigan; Henry Ford Health System;
 Mercy Health Services ST: Michigan IN: HEA SU: PDT


DH -- DE004 -- 6492 02/15/93 09:09 EST
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Publication:PR Newswire
Date:Feb 15, 1993
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