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May – June 2019
5 questions with Robert Coscione
 Robert Coscione, vice president, Provider Network Evaluation and Management, talked with us recently about upcoming changes to our provider network strategy and how we can work more effectively with our physician and hospital partners. Coscione joined Blue Cross Blue Shield of Michigan in January following the retirement of Alison Pollard. He previously served as regional vice president at Anthem Blue Cross.
- How will you be building on the work of your predecessor?
I’ll be continuing Alison’s quality improvement efforts and working to better serve our members and health care providers.
- What do you see as your mission?
A key part of my mission is to improve our interactions with our physicians and hospital partners in four basic areas: communications, education, openness and access to timely, actionable data. For example, we want to improve the provider portal to make it easier for our health care providers to get the information they need about claims status, benefits, eligibility and authorizations. Many phone calls to Provider Inquiry could be avoided if we did a better job of giving them the information they needed online. I will also be helping to facilitate the rollout of Blueprint for Affordability, formerly called Pathway to Risk.
- What can you tell us about Blueprint for Affordability?
It’s a PPO contracting strategy that builds upon our existing value-based reimbursement programs with physicians and hospitals. It includes both upside and downside risk for providers. Our large group customers have been demanding that we put a risk component into the equation to better control cost trends while we work to improve health care quality.
- What are the challenges you face in implementing risk contracts?
An ever-present challenge in risk contracting is to structure the agreements in such a way that we don’t exceed the solvency limits of the risk-based entities we’re negotiating with, while still meeting the demands of the market. We need to work closely with hospitals and physician groups to ensure they have a certain comfort level with this new approach. The reporting tools associated with this program are mission-critical.
- What advice would you offer physicians and hospital executives?
The same advice I would offer a health care plan: You can’t stop change. Advances in technology are creating enormous changes in the marketplace. They’re changing where people receive treatment, how health care providers interact with patients and how patients receive their health care information. We have to recognize that the health care delivery model is changing rapidly because of advances in technology. It’s forcing all of us to adapt.
We have to recognize that the health care delivery model is changing rapidly because of advances in technology. It’s forcing all of us to adapt.
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