We Stand for Affordability
Blue Daily
| 5 min read
Published by BCBSM. Through continuous innovation, B...
Access to affordable, quality health care is our defining purpose at Blue Cross Blue Shield of Michigan. In just the last year, however, skyrocketing prescription drug and medical prices have increased the total amount we pay for our members’ care – by $12 million per day.
In 2024, Blue Cross paid $1.04 in claims for every $1 we earned in premiums.
This is putting pressure on your ability to afford health insurance, since surging medical prices upstream flow downstream into your health insurance premiums and copays.
So – what is Blue Cross doing to keep health care and health insurance affordable for you?
Reducing Our Administrative Spending
We understand that our customers ultimately pay for the business we run. As health insurance costs continue to grow, we are doing our part by reducing what we spend running our own business by $600 million over three years while maintaining the quality of the products and services our customers deserve. Reducing overhead costs and putting advanced technology to work improving the efficiency of our business is a critical component of our efforts.
Negotiating Lower Prices
When our members see their Explanation of Benefits (EOB), they’ll see a “minus discount” line on the statement. That’s a reflection of the lower price we’ve already negotiated with the provider on our members’ behalf.
Because of the size of our membership, we’re able to work with hospitals, doctors and other care providers to secure discounted rates—even for services that may not be covered by your plan. That means you’re not paying the full retail cost of care, and that discount applies simply because you’re a Blue Cross member.
Rewarding Healthy Choices
Blue Care Network was the first health plan in Michigan to launch a product that lowers insurance costs for people who commit to working with their doctors to improve their health. With Healthy Blue Living, we offer lower out-of-pocket costs to members who take steps to manage their health. It’s still helping thousands of people save while living healthier lives.
Partnering to Drive Down Costs
Lasting affordability comes from improving the health care system itself. That's why, for the past 20 years, we've collaborated with physicians and hospitals statewide through our Value Partnerships program—a collection of initiatives designed to enhance quality, reduce costs, and improve patient outcomes.
These partnerships have led to:
Higher-quality care: By sharing data and best practices, we've helped providers implement changes that prevent complications and improve patient safety.
Cost savings: Our collaborative efforts have prevented $6.3 billion in medical expenses over two decades, easing the financial burden on our members and the health care system.
Better patient experiences: Coordinated care models, like the Patient-Centered Medical Home, focus on whole-person health, ensuring patients receive personalized and efficient care.
Preventing Fraud Before It Drives Up Costs
The National Health Care Anti-Fraud Association (NHCAA) estimates financial losses due to health care fraud could be more than $300 billion per year. We've built strong protections against fraud, waste and abuse. Our Corporate and Financial Investigations (CFI) team works to identify and address fraud, waste and abuse by prioritizing patient safety while protecting against financial losses that affect our customers and the health care system. The team is composed of investigators, data analysts and clinical and claims specialists.
Innovating to Lower Costs
We use advanced analytics to help prevent costly health complications for our members who are managing complex conditions. We offer digital tools to make navigating care simpler. We offer programs like Blue Cross Coordinated Care, where nurses work with our members to ensure they get the right care in the right setting at the right time. These innovations and many others help improve outcomes, reduce unnecessary spending, and create a better health care experience—at a lower cost.
Reducing Pharmacy Costs at the Counter
Prescription drug prices are a major driver of health insurance costs. We’re addressing that with smart, proactive programs like Price Edge. Through Price Edge and other drug discount programs, Blue Cross and BCN members saved more than $59.6 million on eligible drugs in 2024.
Helping the Uninsured… AND the Insured
Michigan’s nonprofit hospitals often provide medical care to people without health insurance. Many times, these costs go unpaid. The total cost of uncompensated care is accounted for by hospitals when they negotiate prices with health insurers – meaning these costs flow into the premiums of people with private health insurance.
We believe every person deserves access to health care. We also know that too many people – both uninsured and insured – can’t afford it.
Since 2005, Blue Cross Blue Shield of Michigan has been the largest private funder of Michigan’s network of free community clinics. These local clinics care for thousands of uninsured people every year – keeping them healthy and treating them outside of the hospital. Over time, this effort has helped hospitals avoid $200 million in uncompensated care – preventing those additional costs from flowing into your health insurance premium, while improving the lives of people who are less fortunate.
No cost preventive care
Staying as healthy as possible is one thing we can do to live at our best and help lessen insurance cost pressures. Staying out of expensive hospital care and successfully managing our health conditions is important to promote affordability – and Blue Cross is ready to help. Our members can count on many free or low-cost services built into their insurance benefits – such as preventive care appointments with no copays. We also provide members access to free screenings for high blood pressure, depression, hepatitis and obesity, along with diet counseling and smoking cessation programs. We offer free screenings and counseling appointments specifically for women’s health and for kids.
Lots of choices
For our smallest customers – including small business owners and people who buy their own health plans on the marketplace – choice is an important part of the affordability equation. Our customers can select from many different plan options at different premium amounts, and work with their agents to shop for their most affordable option with ease. For small businesses with under 50 employees, we offer nearly 90 different health insurance product options at different price points. For individuals shopping on the marketplace in 2025, we offered statewide access and a total of 38 different health plan choices.
