BC/BS of Michigan, the heavyweight among Michigan carriers, is reacting to both the downed economy and strides made by its nearest competitor, Priority Health, by launching in 2011 a new slimmed-down commercial PPO that is in line with what other insurers offer. The Michigan Blue plan, with 3.9 million members, dominates the commercial market, but Priority Health, with about 464,000 members, continues to build enrollment. BC/BS of Michigan has the largest Medicare Advantage membership in the state, and Priority is again second. For 2011, just nine carriers will offer MA, down from 13 this year. Nineteen carriers, the same as this year, will sell stand-alone Medicare prescription drug plans, but there will be 12 fewer offerings. BC/BS of Michigan is continuing to support pay-for-performance initiatives–nine so far–and the promise of a tenth next year. The latest initiative is a targeted effort aimed at reducing blood clots in non-surgical patients.