|Michigan Blues Launch Nation’s Largest Program for Patient-Centered Medical Home
Blue Cross Blue Shield of Michigan (BCBSM) said it plans
to designate more than 1,000 physicians in its patient-centered medical
home (PCMH) program, making it the largest such program in the nation.
These physicians represent close to 300 primary care practices, located across Michigan.
The Michigan Blues PCMH program may affect close to 2
million Michigan residents, which makes this state a significant leader
among national discussions and studies regarding the future of
PCMH is an approach in which patients take an active
role in their own healthcare, working closely with their primary care
physicians (pediatricians, internists and family practice doctors)
throughout the journey across the healthcare system. Doctors coordinate
patients’ health status, manage chronic conditions, track all
medications, offer extended office hours and practice ongoing health
management to keep patients healthy and prevent complications.
"Blue Cross’s medical home program is about
strengthening the bonds of doctors and patients to achieve lasting
improvements in healthcare quality," said Daniel J. Loepp, BCBSM
president and CEO.
Many studies have found that having a regular source of
care with the same physician over time leads to better health and lower
overall costs of care. A 2004 report in the Annals of Family Medicine
concluded that if every American had a medical home, healthcare costs
would decrease by 5.6 percent, resulting in national savings of $67
billion dollars per year and improved care quality, BCBSM said.
BCBSM and its physician partners have been testing the criteria for a PCMH program since 2004.
Physicians have been implementing changes in their
practices to prepare for PCMH requirements, including offering extended
office hours, electronic prescribing, performance reporting, test
tracking and care management.
"We are celebrating the first major milestone in an
ambitious program to transform primary care practice in Michigan," said
Dr. Tom Simmer, BCBSM senior vice president and chief medical officer.
"We are recognizing the physicians who are the most advanced in
redesigning their care according to the model for patient-centered
About 3,800 primary care physicians are focusing on at
least one element in the PCMH program.Those 1,000 early adopters who
have made the most progress in transitioning to the PCMH model will be
designated as PCMH practices by BCBSM. The final stages of designation
will be complete by June 15. More physicians can achieve designation as
they progress with implementing PCMH tools and processes, and quality
and use performance.
Because making changes to their practices is costly,
PCMH-designated physicians will be compensated for the time and effort
required to manage their patients’ care across all healthcare
settings. In addition, BCBSM has dedicated close to $30 million from
already-existing physician group incentives toward physician
organizations that are working to meet some or all of the PCMH
Changes that physicians have made in their practices
will benefit all of their patients, including those patients who do not
have insurance with BCBSM.
"Patients who go to patient-centered medical home
practices will receive a holistic and comprehensive approach to their
care," Simmer said. "Medical home physicians will coordinate a
patient’s prescriptions, therapies, tests and visits to
specialists. Patients will have expanded access, including 24-hour
phone access, to their primary care practice to receive guidance and
support for managing health problems. This should reduce
patients’ use of emergency departments for non-emergent
Patients with chronic diseases, such as diabetes and
asthma, will learn to manage their care and stay healthy with guidance
and support from their medical-home team of health professionals.
Address: Blue Cross Blue Shield of Michigan, 600 East Lafayette Blvd., Detroit, MI 48226; (877) 469-2583, www.bcbsm.com.