Michigan Blues launch nation's largest program for Patient-Centered Medical Home

Program designed to strengthen doctor-patient relationship and create long-term improvements in the quality and cost of health care statewide

April 21, 2009

DETROIT - Blue Cross Blue Shield of Michigan today announced plans to designate more than 1,000 physicians in its Patient-Centered Medical Home program, making it the largest such program in the nation. These physicians represent close to 300 primary care practices, located across Michigan. The Michigan Blues PCMH program may affect close to 2 million Michigan residents, which makes this state a significant leader among national discussions and studies regarding the future of health care.

Patient-centered medical home is an approach in which patients take an active role in their own health care, working closely with their primary care physicians (pediatricians, internists and family practice doctors) throughout the journey across the health care system. Doctors coordinate patients' health status, manage chronic conditions, track all medications, offer extended office hours and practice ongoing health management to keep patients healthy and prevent complications.

"Blue Cross's medical home program is about strengthening the bonds of doctors and patients to achieve lasting improvements in health care quality," said Daniel J. Loepp, president and CEO of the Michigan Blues.

Many studies have found that having a regular source of care with the same physician over time leads to better health and lower overall costs of care. A 2004 report in the Annals of Family Medicine concluded that if every American had a medical home, health care costs would decrease by 5.6 percent, resulting in national savings of $67 billion dollars per year and improved care quality.

The Michigan Blues and its physician partners have been testing the criteria for a Patient-Centered Medical Home program since 2004. Today's announcement is possible because of an intense effort by physicians. Physicians have been implementing changes in their practices to prepare for PCMH requirements, including offering extended office hours, electronic prescribing, performance reporting, test tracking and care management.

"Today we are celebrating the first major milestone in an ambitious program to transform primary care practice in Michigan," says Tom Simmer, M.D., BCBSM senior vice president and chief medical officer. "We are recognizing the physicians who are the most advanced in redesigning their care according to the model for patient-centered medical practice."

About 3,800 primary care physicians are focusing on at least one element in the PCMH program. Those 1,000 early adopters who have made the most progress in transitioning to the PCMH model will be designated as Patient-Centered Medical Home practices by the Michigan Blues. The final stages of designation will be complete by June 15. More physicians can achieve designation as they progress with implementing PCMH tools and processes, and quality and use performance.

Because making changes to their practices is costly, PCMH-designated physicians will be compensated for the time and effort required to manage their patients' care across all health care settings. In addition, the Michigan Blues have dedicated close to $30 million from already-existing physician group incentives toward physician organizations that are working to meet some or all of the PCMH features. Changes that physicians have made in their practices will benefit all of their patients, including those patients who do not have insurance with the Michigan Blues.

"Patients who go to Patient-Centered Medical Home practices will receive a holistic and comprehensive approach to their care," Simmer said. "Medical home physicians will coordinate a patient's prescriptions, therapies, tests and visits to specialists. Patients will have expanded access, including 24-hour phone access, to their primary care practice to receive guidance and support for managing health problems. This should reduce patients' use of emergency departments for non-emergent conditions."

Patients with chronic diseases, such as diabetes and asthma, will learn to manage their care and stay healthy with guidance and support from their medical-home team of health professionals.

This PCMH program is part of Value Partnerships, a collection of collaborative initiatives among physicians, hospitals and the Michigan Blues, all aimed at improving quality in medical care.

Blue Cross Blue Shield of Michigan, a nonprofit organization, provides and administers health benefits to 4.7 million members residing in Michigan, in addition to members of Michigan-headquartered groups who reside outside the state. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. For more company information, visit bcbsm.com.

©1996-2014 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. We provide health insurance in Michigan.

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