2010 Managed Healthcare Industry Forum Presents:

Health Plans Involvement in
Patient-Centered Medical Homes and ACOs

Monday, November 8, 2010 • New York City

BIOGRAPHICAL PROFILE

Thomas L. Simmer, M.D. Sr. Vice President & Chief Medical Officer Blue Cross Blue Shield of Michigan

Dr. Simmer is responsible for reimbursement to more than 55,000 clinicians throughout the State of Michigan. Thirty-eight thousand physicians participate in Blue Cross Traditional and PPO plans. He oversees BCBSM medical policy, professional payment policies and programs to improve the quality, cost, and access to medical services. Under his leadership BCBSM has implemented physician incentive programs to promote collaborative improvement programs for more consistent care for persons with chronic illness and more cost effective prescribing patterns. Dr. Simmer is responsible for a well-designed collaborative partnership with physician organizations designed to achieve meaningful quality improvement while reducing costs. He has provided leadership to the Michigan Quality Improvement Consortium (MQIC) which works with Health Plan Medical Directors across Michigan to create and facilitate implementation of evidence-based guidelines.

In 2010, Dr. Simmer was awarded the “Healthcare Hero” award by Crain’s Business Detroit for his work promoting healthcare transformation in Michigan through the Patient Centered Medical Home initiative and other collaborative programs with physician organizations throughout Michigan.

Prior to joining the Blues, Dr. Simmer served as Vice President of Health and Medical Affairs and Medical Director for Health Alliance Plan. He also served as Associate Program Director for the Internal Medicine Residency Program at Henry Ford Hospital and was the recipient of several Distinguished Service Awards.

He graduated from the Wayne State University School of Medicine and earned his bachelor's degree from the University of Michigan. Dr. Simmer is a member of the Michigan State Medical Society and a Fellow of the American College of Physicians.