While other plans pledge to curb the rising cost of care, we achieve actual results through alternative agreements with those responsible for treating our members—providers.

What do we mean by value?

Value-based care means paying providers based on results, not patient volume. 
Value-based care gives providers flexibility to deliver the right care at the right time while holding them accountable for improving patient outcomes.

We achieve this by:

• Controlling costs to keep premiums affordable.
• Improving overall health outcomes and decreasing higher-cost hospital visits.
• Offering members richer benefits, higher-quality care and lower premiums.
• Recognizing provider expertise and supporting them in what they do best.
• Rewarding providers for using the right care, at the right time, in the right place.

See the difference.

Our research shows that, through value-based agreements, we can work with entire health care systems, such as Corewell Health, to demonstrate a real difference in outcomes. Compared to other hospital systems in the Priority Health network, from 2019 – 2022, Corewell Health showed a:

• 15% increase in primary care visits.
• 17% increase in outpatient behavioral health visits.
• 6% decrease in hospital admissions.
• 2% decrease in emergency room use.

How does that create value?

When primary care and outpatient visits increase, behavioral health needs are met, chronic conditions are better managed and health concerns are addressed earlier, resulting in a reduction of higher-cost services such as emergency room care and hospital admission.

• Individual plans: West Michigan premiums for individual plans are 10% below the national average and lower than 72% of rating areas nationwide.
• Small business plans: West Michigan premiums for small group plans are 29% below the national average and lower than 94% of rating areas nationwide.

Priority Health believes in creating value.

Results show that our value-based care arrangements benefit our doctors, our members and our communities. We see members getting better care, health systems earning more and savings resulting in reduced health plan premiums.

Get caught up on the conversation.

Priority Health remains committed to alternative payment models. Read the following articles about the benefits of value-based arrangements from across the industry.