Michigan's economy has begun to recover from its bottom, but health plan purchasers are only coming back into the market cautiously. Demand is up for products that will yield better medical outcomes, more productive employees and a focus on population management. To that end, leading health plans in the state have gotten on board with innovative care delivery concepts like the patient-centered medical home. Blue Cross Blue Shield of Michigan has the largest single-state medical home initiative in the country, now designating 1,800 physicians across 500 practices, with plans to designate 3,200 more doctors. Priority Health has a similar, but smaller, initiative and several other concepts in testing to help it continue to erode the leading Blue plan's share. Providers are also scrambling to align themselves into accountable care organizations in preparation for Medicare's efforts to contract ACOs in 2012. The Southeast Michigan E-prescribing Initiative, or SEMI, has made the state the third largest in e-prescribing volume, but the effort remains confined to the areas around Detroit. Employers continue to demand wellness programs from all insurers, and in fact did not drop these programs when they cut back during the recession, suggesting they see them as high-value. Consumer-driven plans continue to gain favor in Michigan, where they have been slow to catch on. With the purchase of an account-based plan by a unionized education group in Jackson, the floodgates may be about to open. Medication therapy management programs have also started to show some acceptance in commercial health plans. Priority Health has such a program in the West Michigan market on a pilot basis.