PROGRAMS Patient-Centered Medical Home

Since 2009, Blue Cross Blue Shield of Michigan’s Patient-Centered Medical Home designation program has fueled statewide movement of primary care into a team-based, proactive model of efficient, cost-effective care centered around the patient. No other health plan-led PCMH designation program has the size or results of the Blue Cross PCMH designation program.  PCMH-designated providers are prevalent across Michigan.

In our PCMH model of care, patients get the right care at the right time in the right setting. PCMH-designated practices have saved $626 million over 9 years, because doctors and their care teams have prevented disease, reduced hospitalizations and ER visits, tracked patient care, and better managed common and chronic medical conditions to keep patients healthy.

Blue Cross PCMH-designated practices consistently outperform non-designated practices in clinical quality and utilization measures.

CONTACT

Lisa Rajt
Manager, PCMH & PDCM

lrajt@bcbsm.com

$626 million
IN AVOIDED COSTS

  • 4,704 PCMH-designated physicians in 1,738 PCMH-designated practices
  • Located in 81 of Michigan’s 83 counties
  • 2.6 million Blue Cross beneficiaries
  • 38 percent lower rate of adult ambulatory care sensitive inpatient stays
  • 30 percent lower rate of adult primary care sensitive ER visits
  • 35 percent lower rate of pediatric primary care sensitive ER visits

 

In Michigan, PCMH-designated practices are also designated as Total Care providers. Total Care is the nation’s largest integrated network of value‐based care providers. It givesemployers access to similar quality programs when they have employees in multiple states.

To find a doctor with Total Care designation use the Find a Doctor feature on bcbsm.com.

Additional Resources and Information

Several published studies have measured the cost and quality success of the Blue Cross PCMH model, including:

Click here for more information on provider reimbursement structure for PCMH.

Patient Centered Medical Home – Neighborhood

The Patient Centered Medical Home program enhances patient-centered care across the system by encouraging primary care and specialist physicians to coordinate their shared patients’ care. Specialists implement PCMH-Neighbor capabilities to manage and improve care across settings.

PCMH Physician Toolkit
PCMH-designated practices can use the materials in the toolkit to help communicate to their patients about PCMH. 

Awards and Recognition

2010

Blue Works Award

Blue Cross and Blue Shield Association, a “best of the best” clinical excellence award among national Blues’ plans