MARSP News & Announcements

The Verification of Coverage (VOC) was sent to all MPSERS retirees in May who are on the Blue Cross Blue Shield PPO plan. Members who are on HMO plans will not receive this form. Remember to complete the form on behalf of all members on your contract for your medical and prescription drug coverage. The deadline is July 15. You must respond even if you don’t have any other coverage. Failure to do so will result in cancellation of your coverage. There is up to a six-month wait to be reinstated by the Office of Retirement Services. The simplest way to respond is by calling 1-877-445-2192 between 8 a.m. and 8 p.m. Monday through Friday.

You must respond, even if you don’t have any other coverage. If you don’t respond, your Retirement System coverage will be cancelled on September 1, 2015.

Be sure to complete all areas of the form that apply and return no later than July 15, 2015. One form will be mailed to the contract holder to complete for all members on the contract.  For the majority of members, only question 1 will apply if you have no other coverage. You will need to simply indicate that you have no other coverage, sign, date, and return the form, or reply via phone, online, or fax.

You have four ways to reply.

1. Sign and return the completed form in the envelope provided.
2. Go online to https://mpsers.coverageupdatecenter.com to complete the form.
3. Call Blue Cross Blue Shield at 1-877-445-2192; TTY number 1-800-735-2929. If you have no other coverage, your response will be collected via the automated telephone system. If you have other coverage to report, you will be connected to a customer service representative to provide your other coverage information.
4. Sign and fax the completed form to 1-402-384-6310.

If you did not receive a form, call 1-877-445-2192 and dial “0” when asked for you VOC reference number. It will cycle through this prompt twice, however, choosing “0” each time will send you to a customer service representative.

Priority Health is launching a new digital magazine called ThinkHealth. ThinkHealth leverages experts within Priority Health as well as thought leaders and third party organizations across the health insurance, health care technology and fitness industries to provide thought-provoking, educational content to aid Michigan consumers in their health and wellness decisions.

Check out the new magazine at http://thinkhealth.priorityhealth.com

Click here to view the changes in the MPSERS health care plans for 2015 in the November/December VANGUARD.

Priority Health will be holding 90-minute informational meetings for MPSERS members to learn more about the health care options they offer to public school retirees.  Any retirees interested in attending can register by calling Priority Health customer service toll-free at 888-389-6648, x3 or online at Priority Health’s website.

The Office of Retirement Services announced that Delta Dental will be the dental provider for 2014. The plan benefits will be the same as previously published in VANGUARD.

The presentations given at the MARSP 2014 Health Insurance Update are now available online.  Each presentation can be found on the individual provider’s page in the “Health Insurance” section of this website or by clicking on the links below.

Master Health Care Plan (including prescription drug plan)

Blue Cross Blue Shield PPO – 2014 Health Insurance Update

Catamaran Rx – 2014 Health Insurance Update

HMOs

Blue Care Network Advantage – 2014 Health Insurance Update

HealthPlus – 2014 Health Insurance Update

Priority Health – 2014 Health Insurance Update

Dental & Vision

Blue Vision/VSP – 2014 Health Insurance Update

Delta Dental – 2014 Health Insurance Update

Click here to find a doctor with the Patient-Centered Medical Home (PCMH) designation with Blue Cross Blue Shield.

Putting the focus on the patient: Medical home defined

Submitted by Blue Cross Blue Shield of Michigan

The Patient-Centered Medical Home (PCMH) places the patient and primary care practice at the center of care and creates a healthcare setting that is a collaborative partnership between the patient and their personal physician.Blue Cross Blue Shield of Michigan’s patient-centered medical home program is transforming primary care across Michigan. The PCMH model was developed to strengthen the doctor-patient relationship and improve health care quality by helping primary care doctors and their health care teams more effectively manage their patients’ care.

To accomplish this goal, PCMH practices use such features as e-prescribing, chronic disease management, 24-hour access to a clinical decision-maker and patient registries to track and monitor care. Health care teams also work closely with patients to help them set individualized health goals and encourage them to take a more active role in their own health management.

In July 2012, Blue Cross Blue Shield of Michigan designated 994 primary care practices — representing 3,017 primary care doctors across the state — as PCMH practices.

What is the PCMH?

The PCMH is a model of healthcare based on an ongoing, personal relationship between a patient, doctor and the patient’s care team.  Whatever the medical needs – primary or secondary, preventive care, acute care, chronic care, or end-of-life care – the patient has a medical “home”; a single, trusted doctor and care team, through which continuous, comprehensive and integrated care is provided.

The PCMH model includes a personal doctor and care team that will provide medical care.  When specialty care is needed, at the patient’s request, the doctor and care team will personally manage, facilitate and coordinate the care with appropriate qualified professionals, such as hospitals, nursing homes, pharmacies and related community resources.

The PCMH model proposes to improve primary care by focusing on the patient-doctor relationship and to strengthen this dynamic through a more comprehensive approach to patient care and more active patient involvement.

What the Blues are Doing

Participating Blue Cross and Blue Shield companies are working with doctors, healthcare quality advocates, governmental entities, consumer advocate groups and employers to develop and test the PCMH model.

BCBS companies have PCMH initiatives in 40 states across the country and Washington, DC that explore effective means of provider reimbursement and integrate quality improvement, care management and patient educational tools into primary care practices.  More than 5 million members are currently benefitting from care delivered through a BCBS PCMH initiative.

BCBSA works with outside quality and research organizations to ensure the effectiveness of PCMH pilots to enhance the primary care practice infrastructure and improve clinical quality, outcomes, affordability, and physician and patient satisfaction. Additionally, BCBSA serves as conduit for patient advocacy groups, employers, business coalitions, physician professional societies, government officials and other interested stakeholders wanting to partner with BCBS companies to further the PCMH model of care.

Patient satisfaction, delivered in accordance with an agreed care plan, is the hallmark of the PCMH.  Patients who receive care through the PCMH model will benefit from the following:

• Access to doctors that utilize improved technologies to stay better connected with the medical community and manage care more efficiently.
• Improved access to care through easier scheduling of appointments and extended office hours.
• More focused, personal interaction with doctors and care teams that will help navigate through the complex healthcare system.
• A more comprehensive delivery of primary care through the improved coordination of care, managed by the patient’s personal doctor and their care team.

To find a physician with the PCMH designation, go to www.bcbsm.com and do the following:

• Click on “Advanced Search”.
• Select how many miles you are willing to drive to receive care and enter your zip code.
• Select “MPSERS” as your health plan
• Select “MPSERS Blue Preferred (PPO)” if you are non-Medicare or “MPSERS Medicare Plus Blue” if you are Medicare.
• Enter the 3-letter prefix from your Blue Cross card if it is different than what is listed on the screen.
• Select “Doctor, specialist, and medical professional” in the Step 3 box for “What are you looking for?”
• Select “Patient-Centered Medical Home” in the Step 4 box and click on “Go”.
• This will generate a list of providers in your area.
  • If there are no providers in your area, you may need to expand the number of miles you are willing to travel.

Click here to view the screenshots of this written procedure.

The Senate Government Operations Committee just now voted to move three bills to the Senate floor related to Medicaid expansion in Michigan.  The Senate Healthy Michigan workgroup developed a substitute for HB 4714 that builds upon the Medicaid expansion and reforms developed by the House, and passed the bill on a 4-0 vote.  The version of HB 4714 passed by the committee today is supported by Governor Snyder and Senate Majority Leader Randy Richardville.
 
Additionally, on 3-2 party-line votes, the Committee passed Senate Bill 422, sponsored by Senator Bruce Caswell (R-Hillsdale), and Senate Bills459 and 460, sponsored by Senator Patrick Colbeck (R-Canton Twp.). Senate Bill 322 would provide for state health care coverage to individuals under 100% of the Federal Poverty Level who do not otherwise currenty qualify for health insurance under existing programs, while Senate Bills 459-460 seek to create a free market, high deductible, private sector alternative to the Medicaid expansion.
 
The Senate will consider all three bills when it returns to session on August 27.