Patient-Centered Medical Home

In 2009, Blue Cross Blue Shield of Michigan and its physician partners launched the nation’s largest Patient-Centered Medical Home program. Developed in partnership with providers, the Patient-Centered Medical Home program is transforming the primary health care system into a model of efficient, cost-effective care centered around the patient.

The Value Partnerships PCMH model follows these principles:

  • Physicians will deliver higher-quality, lower-cost care when they use processes and tools that engage patients in a team approach to managing their health, and when they coordinate care for patients and give them access to care in the right setting.
  • Patients who have full access, including after hours, to their primary care physician will be more likely to receive the care they need in the appropriate setting, and will decrease their use of the emergency department for non-emergency conditions.
  • Primary care physicians who effectively manage their patients’ chronic conditions may help prevent hospitalizations, thus improving care outcomes and decreasing costs.
  • Physicians can more effectively manage their patients’ health through the use of secure, electronic patient registries and performance reporting tools.

In 2012, the Michigan Blues designated 3,029 physicians in 995 practices across the state as patient-centered medical homes based on their progress in implementing PCMH capabilities and qualities, and based on high performance on quality and use measures.

An additional 3,500 physicians are improving their processes and implementing medical home capabilities in an effort to earn designation in coming years. Together, all 6,500 physicians are improving the health care system in Michigan.

PCMH-designated physicians earn an enhanced fee for office visits, to compensate them for the extra time and effort required to practice as a medical home.

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How are we transforming health care?

Launched in 2012, three new Collaborative Quality Initiatives (CQI) are among the latest Value Partnerships program aimed at improving health care value.

The three CQIs are introduced in the fifth annual Partners in Health Care Report: Transforming Health Care.

Since 2005, the Blues have partnered with tens of thousands of physicians across the state – and nearly every hospital – through the groundbreaking Value Partnerships program. It’s a program that’s transforming health care in the state, improving quality and outcomes and bringing greater health care value to Michigan,” President and CEO Daniel J. Loepp said in the report’s introduction.

Following are examples of how Collaborative Quality Initiatives are making a difference:

  • The 33 hospitals on the BMC2 angioplasty CQI reported a 20-percent decrease in hospital deaths.
  • The Advanced Cardiovascular Imaging Consortiumreduced radiation doses by more than 60 percent.
  • The Michigan Surgical Quality Collaborative reported a 15-percent reduction in length of stay for hospital patients.
  • Four of the longest-running CQIs saved more than $232 million statewide over three years. BCBSM savings were over $70 million during this time period.
Three new CQIs launched in 2012

  • Michigan Arthroplasty Registry for Collaborative Quality Improvement, which aims to improve the quality of care for patients undergoing hip and knee joint replacement surgery.
  • Michigan Radiation Oncology Quality Consortium, which aims to determine which breast and lung cancer patients are most likely to benefit from intensity modulated radiation therapy.
  • Michigan Urological Surgery Improvement Collaborative, which is working with urologists across Michigan to improve health care outcomes for men with newly diagnosed cases of prostate cancer.
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