Blue Cross Blue Shield of Michigan designates 1,243 physician practices, containing more than 3,770 physicians, in nation’s largest patient-centered medical home program

Blue Cross Blue Shield of Michigan designates medical home physicians in 71 of Michigan's 83 counties

July 22, 2013

DETROITBlue Cross Blue Shield of Michigan has designated 1,243 Michigan physician practices as patient-centered medical homes for 2013. The 1,243 practices, containing more than 3,770 physicians, make this the country’s largest PCMH effort of its kind for the fifth consecutive year. 

Through patient-centered medical homes, primary care physicians lead care teams that work with patients to keep them healthy and monitor their care on an ongoing basis. PCMH teams coordinate patients' health care across all locations for care, to help patients' meet their personal health goals.

"The Michigan Blues' medical home model is working," said Daniel J. Loepp, Blue Cross Blue Shield of Michigan president & CEO. "Verified data show improved patient outcomes and millions of dollars in cost savings. Additionally, physicians are making determined efforts to earn designations. Their overwhelming support is the biggest indication that this program is benefitting patients statewide."

A recent analysis shows that the program saved approximately $155 million over its first three years, because of improved quality of care and preventive care that helped patients avoid emergency room visits and hospital stays.

"In Blue Cross' program, each patient has his or her own health care team. The team works together, in partnership with the patient, to focus on each patient's personal goals and needs," said David Share, M.D., MPH, Blue Cross Blue Shield of Michigan senior vice president, Value Partnerships. "Physicians and their care teams are improving patient outcomes, which leads to lower costs because there is less need for testing and hospital care."

PCMH practices offer their patients services that may not be offered at non-designated practices, such as 24-hour access to the care team. PCMH practices coordinate specialist and other care, such as nutrition counseling, home care or links to community services. They also teach patients how to manage conditions such as asthma and diabetes.

More than 1.1 million Blue Cross Blue Shield of Michigan members, and close to 2 million patients across the state, have access to a Blues' PCMH-designated practice.

Data from 2013 show that the Michigan Blues' PCMH practices have lower rates of patients being hospitalized and visiting the emergency room than nondesignated practices. In fact, emergency department visits are particularly lower in cases where appropriate care in a doctor's office or clinic is preventing a medical condition from worsening (referred to as primary-care sensitive).

PCMH-Designated Practices compared to nondesignated practices

For Adults (age 18 – 64) per 1,000 Rate
     Emergency Department visits -8.8%
     Primary-care Sensitive Emergency Department visits -11.2%
     Ambulatory-care Sensitive Inpatient Discharges -19.1%
     High-tech radiology services -7.3%
For Children (age 0 – 17) per 1,000 Rate
     Emergency Department visits -17.7%
     Primary-care Sensitive Emergency Department visits -23.9%

 

"Now that we're in our fifth year of this program, we're seeing measurable improvement in patient outcomes, and doctors are telling us that their practices are more fulfilling, effective and efficient," Share said. "In the last two years, specialist physicians have begun collaborating with primary care physicians and changing their care processes guided by the PCMH model, so that patients' care is truly managed across the spectrum."

The number of physicians earning PCMH designation from Blue Cross Blue Shield of Michigan has tripled since Blue Cross Blue Shield of Michigan first launched the program in 2009, when 1,200 physicians were designated. Designation lasts for one year, July through June. Physician practices work to earn designation each year.

Blue Cross Blue Shield of Michigan bases half of the designation score on a practice's PCMH capabilities – such as 24-hour access for patients and active care management – and half of the designation score on care quality and utilization measurements, such as number of emergency room visits among patients.

To search online for a Blue Cross PCMH-designated physician, go to bcbsm.com and click on Find a Doctor on the left side of the page. 

The PCMH initiative 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 is a nonprofit corporation and independent licensee of the Blue Cross and Blue Shield Association. For more company information, visit bcbsm.com.     

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