Blue Cross Blue Shield of Michigan designates record number of physician practices to nation's largest patient-centered medical home program

Program nearly triples in size since 2009 launch

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Aug 06, 2012, 10:29 ET

DETROIT, Aug. 6, 2012 /PRNewswire/ -- Blue Cross Blue Shield of Michigan has designated a record number of Michigan physician practices across the state as patient-centered medical homes, a 28 percent increase over the number of PCMH practices designated in 2011. The 994 practices, comprising 3,017 physicians, make this the country's largest PCMH effort of its kind for the fourth consecutive year.

Through patient-centered medical homes, primary care physicians (pediatricians, internists and family practice doctors) 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, track patients' conditions and ensure that they receive the care they need.

"This program benefits patients by improving the doctor-patient relationship. Patients have better access to their doctors' offices, not only when they are sick, but when they need advice and guidance to keep them healthy," said Thomas L. Simmer, M.D., BCBSM senior vice president and chief medical officer. "Physicians and their care teams are improving patient outcomes, which leads to lower costs because there is less need for testing and hospital care."

The benefits of PCMH reach all of a practice's patients, regardless of whether the patient is insured by Blue Cross. The Blues' Patient-Centered Medical Home Program improves care for millions of Michigan residents through designated physician offices as doctors follow the PCMH approach for their entire patient populations.

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

Data from 2012 show that the Michigan Blues' PCMH practices have patients who require fewer hospital admissions and emergency room visits than patients in non-designated practices.

For example, adult patients in Blue-designated PCMH practices had a 23.8 percent lower rate of hospital admissions for certain conditions than non-designated practices. These are examples where appropriate care in a doctor's office or clinic is preventing a medical condition from worsening.

Blue-designated PCMH practices also had an 8.3 percent lower rate of adult high-tech radiology use, a 9.3 percent lower rate of adult ER visits and a 3.0 percent higher rate of dispensing generic drugs over non-PCMH doctors.

"The patient-centered medical home is key to improving health care in Michigan and in the nation. Our model enables doctors to manage their patients' care continually, rather than just fix their ailments from time to time," Simmer said. "This program is motivating physicians across Michigan to transform their practices into patient-centered medical homes."

In addition to those primary care physicians who BCBSM has already designated, close to 4,000 primary care physicians in Michigan are working toward the Blue designation by transforming how their practices deliver health care services to patients. The number of physicians earning PCMH designation from BCBSM has nearly tripled since BCBSM 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. Approximately 75 percent of practices designated in 2009 have remained designated all four years.

The Blue Cross Blue Shield of Michigan Patient-Centered Medical Home Program continually evaluates both the process of care and performance to designate physicians. Half of the designation score is based on a practice's PCMH capabilities – such as 24-hour access for patients and active care management. The other half of the designation score is based 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 Doctor" at the top 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. To learn more about this comprehensive effort, go to valuepartnerships.com.

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.

SOURCE Blue Cross Blue Shield of Michigan