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Hospital and Physician Update

November – December 2019

More than 4,700 physicians earn PCMH designation in program’s 11th year

As you may have read in the November Record, Blue Cross Blue Shield of Michigan announced that it has designated 4,704 physicians in 1,738 primary care practices statewide as patient-centered medical homes. This is the largest number to earn designation in the program’s 11-year history.

Each year since the designation program began, data has shown that patients in PCMH practices, compared to non-PCMH practices, receive preventive care at higher rates and have fewer ER visits and hospital stays. This also results in prevented costs, saving patients money on co-pays and co-insurance. In fact, the program has prevented $626 million in claim costs in its first nine years.

In 2019, PCMH-designated practices, compared to non-designated practices, had:

  • 29% less adult emergency department visits for common chronic and acute conditions, such as diabetes
  • 38% less adult hospital stays for conditions that respond to office-based care
  • 12% lower use of high-tech radiology services for adults
  • 35% less pediatric emergency department visits for common chronic and acute conditions, such as asthma

PCMH practices offer capabilities and services that patients typically may not find at non-designated practices. For example:

  • 24-hour telephone access to the care team
  • Coordination of specialist and complementary care
  • Patient education, such as how to manage asthma or diabetes
  • Test tracking and follow-up, to ensure patients receive needed tests and are informed of results
  • Medication review and management
  • Connections to community and support services
The PCMH program, part of Value Partnerships, is the foundation of Blue Cross’ collaborative efforts with providers to deliver accessible, high-quality, affordable health care to the people of Michigan. To learn more, go to valuepartnerships.com and click on the Programs tab.
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