Patient-centered medical homes boom in Mich.

Blue Cross Blue Shield of Michigan has doubled the number of physicians it considers to be part of patient-centered medical homes (PCMH) since 2009, now designating 2,500 Michigan physicians in roughly 770 practices as PCMH providers.

Marking an increase of 700 physicians from 2010 and a doubling of the 1,200 physicians qualifying for PCMH status since the initiative’s 2009 launch, Blue Cross Blue Shield’s primary care model represents the largest composition of PCMHs in the country, according to the Detroit-based payor.

The non-profit corporation touted a 6.3 percent reduction in high-tech imaging and a 6.6 percent lower rate of ER admissions for PCMHs as signs of the model’s improved quality and efficiency. PCMHs are led by internists, family practice physicians and pediatricians and focus on individual patients’ health goals and needs, emphasizing continuous monitoring and coordination of care.

Blue Cross Blue Shield of Michigan determines whether providers qualify for PCMH status based on the practice’s capabilities and performance. For the former, a provider’s score increases if it offers 24-hour telephone access between patients and caregivers, uses disease registries and employs systematic methods for patient notification and management. On the performance side, Blue Cross Blue Shield of Michigan evaluates utilization of services, including imaging, as well as the implementation of evidence-based care and trends in ER visits.

“This program gives Michigan residents closer relationships with their doctors, not only when they are sick, but when they need advice and guidance to keep them healthy,” said Thomas L. Simmer, MD, senior vice president and chief medical officer for Blue Cross Blue Shield of Michigan.

The payor estimated that the PCMH initiative, which is part of Blue Cross’s Value Partnerships program, reaches millions of patients, while adding that 2,500 additional physicians continue to seek PCMH designation from the payor.

 

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