PCMH practices with care management services now identified in provider search tool

Primary care providers who meet a specific threshold for delivering in-office care management and are designated as Patient-Centered Medical Homes are now included in the Find a Doctor search tool on bcbsm.com.

To find care management service providers, Blue Cross Blue Shield of Michigan members can enter their search parameters as they normally would for a primary care physician. Once the results load, members can filter the list to see physicians who offer Provider-Delivered Care Management. Under the Area of Focus section, they can select PCMH with Care Management.

To be included in the filter, physicians must be:

• PCMH-designated for the Sept. 1, 2019, through Aug. 31, 2020, program year
• Providing care management using a care team
• Using the 12 care management codes for 1% of eligible members on at least two different days during calendar year 2018

These criteria are less stringent than the criteria to receive value-based reimbursement for Provider-Delivered Care Management, which requires care management delivered to 3% of eligible members on at least two different days. In other words, a provider who’s included in the search functionality on bcbsm.com isn’t guaranteed to receive value-based reimbursement for Provider-Delivered Care Management.

Information about which physicians provide PCMH with care management will be updated annually in the fall.

If you’re a PGIP-participating physician organization, you may submit questions after logging in to the PGIP PO collaboration site. If you are a primary care physician, you may submit questions to your PGIP physician organization.