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.


Value Partnerships

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$626 million

  • 4,713 PCMH-designated physicians in 1,641 PCMH-designated practices
  • 244 Collaborative Care-designated practices across Michigan
  • Located in 96% of Michigan counties that have primary care providers
  • 3 million Blue Cross members
  • 37.5% lower rate of adult ambulatory care sensitive* inpatient stays
  • 26% lower rate of adult primary care sensitive** ER visits
  • 25% lower rate of adult readmissions to the hospital
  • 40% lower rate of pediatric primary care-sensitive** ER visits
*Ambulatory care-sensitive conditions are those that shouldn’t require inpatient hospitalization if appropriately managed by a primary care physician.
**Primary care-sensitive conditions are those that should be managed by a primary care physician so that an emergency department visit isn’t necessary.


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 gives employers 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

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


Blue Works Award

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