How Organized Systems of Care Are Changing Michigan Health Care for the Better
One of the major problems with the U.S. health care system is that is incredibly fragmented. Traditionally, medical professionals face many barriers to effective and timely communication with one another when treating patients in different settings, and as a result, care is often poorly coordinated, inefficient and costly. That was the primary motivation which inspired Blue Cross Blue Shield of Michigan to launch its nationally recognized, award-winning Patient-Centered Medical Home program in 2009.
The idea behind the medical home program is that a team of professionals with different skills and responsibilities collaborating in a primary care practice can provide the best possible care to patients assuring their needs are met. These teams are led by a physician and can include a nurse, care manager, social worker, nutritionist, clinical pharmacist and medical assistant, who all work together and communicate with each other, and professionals in other practices and hospitals, to tailor care to the patient’s needs. It works much better than if an overwhelmed doctor tried to do everything alone.
This model has worked so well to lower costs and improve care that Blue Cross, in partnership with it physician organization partners, decided to expand the basic medical home concept to add specialists and hospitals. Now, patients have access to an Organized System of Care — a whole community of caregivers who share and coordinate responsibilities for every aspect of a patient’s care, with the goal of delivering higher quality, higher value care for patients.
Here’s what it means for you as a patient: When you’re part of an Organized System of Care, you won’t need to get the same blood test done multiple times. You can get one test done and the results will go to both the provider treating your diabetes and the one treating your heart condition. Those doctors will not only share the test results, but they will coordinate treatment plans, including prescribed medications, to help you manage both conditions.
That’s just one example of how an Organized System of Care ensures collaboration among your caregivers so that the care you receive results in the highest quality outcomes with the result that care is more affordable and leaves you as healthy as possible.
Organized Systems of Care benefit everyone in Michigan, not just those dealing with chronic diseases. Just choose a Patient-Centered Medical Home practice and you’ll know you have a team that can both provide high-quality, coordinated care when you need it and help you stay healthy. You’ll know that your participating providers are committed to tracking their own performance, establishing performance goals, lowering health care costs and improving quality.
Patient-Centered Medical Homes and Organized Systems of Care don’t just benefit patients. Doctors are more able to focus on their core mission — helping patients — because the process is much more systematic, organized and effective. There are no more repeat services or confusion over who is responsible to follow up with patients or what treatments they should receive. Physicians who are designated as Patient-Centered Medical Home providers and who participate in Organized Systems of Care are rewarded for cost-effective care and improving patients’ health outcomes so they have the resources they need to do their best for you and the rest of their patients.
The roughly 15,000 physicians who are part of an Organized System of Care in Michigan are helping to keep more than 1.2 million Blue Cross members healthy.
David A. Share, MD, MPH, retired Senior Vice President, Value Partnerships, at Blue Cross Blue Shield of Michigan.
This post was originally published on MIBuesPerspectives.