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Blue Cross Blue Shield of Michigan Designates More than 1,800 Physicians in Nation's Largest Patient-Centered Medical Home Program

Wednesday, June 23, 2010 General News J E 4
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Goal is to redesign primary care system for improved health care outcomes

DETROIT, June 23 /PRNewswire/ -- Blue Cross Blue Shield of Michigan has designated more than 1,800 physicians in roughly 500 practices across the state as patient-centered medical homes (PCMH), securing the initiative's position as the largest PCMH effort in the nation.  The number of designated physicians grew by roughly 50% over the 1,200 designated PCMH physicians in 2009.

In the patient-centered medical home, primary care physicians (pediatricians, internists and family practice doctors) lead care teams that bring intensive focus to their patients' individual health goals and needs.  The care teams work with patients to keep them healthy and monitor their care on an ongoing basis.  PCMH teams coordinate patients' health care using registries to track patients' conditions and assure they receive the care they need.  They offer extended access to the care team, coordinate complementary care - such as nutrition counseling - and help patients learn to self manage conditions such as asthma and diabetes.  They make sure that a patient doesn't get lost in the system.

"Blue Cross is working in partnership with some of Michigan's leading health care professionals to improve access for patients, improve quality and lower costs," said Thomas L. Simmer, M.D., senior vice president and chief medical officer for BCBSM.  "People want closer relationships with their doctors, not only when they are sick, but when they need advice and guidance to keep them healthy.  This program builds the type of primary care system the people of Michigan want for their families."

Preliminary data shows that PCMH-designated doctors are succeeding in managing their patients' care to keep them healthy and prevent complications that require expensive medical services to treat.   For example, a review of data shows that PCMH practices have a 2 percent lower rate of adult radiology usage than non-PCMH practices, and PCMH practices have a 2.6 percent lower rate of adult inpatient admissions than non-PCMH practices.

About 5,000 primary care doctors in Michigan are working toward designation as PCMH practices by transforming how their practices deliver health care services to patients.

"Physicians recognize the value that patient-centered medical home provides to their patients, and thousands are working hard to gain designation by Blue Cross," Simmer said.  "Our designations have grown from 1,200 to 1,800 in just one year, and I'm anticipating they will continue to increase as more physician practices bring new capabilities online in the coming months and years."

Simmer notes that while 1,800 of the 5,000 doctors attempting designation actually achieved it for 2010, the efforts of those other 3,200 physicians should be commended for their work in supporting the PCMH model of care.

"All of these physicians are partnering with Blue Cross through this initiative to improve the primary care environment throughout the state," Simmer said.  

The benefits of PCMH reach to all the practices' patients, because not all patients walking through the doors of a PCMH practice are insured by Blue Cross.  The Blue Cross patient-centered medical home initiative is reaching close to two million Michigan residents through designated physician offices today.

The Blue Cross Blue Shield of Michigan patient-centered medical home program uses a model that considers both process of care and performance to designate physicians.  One-half of the designation score was based on the amount of PCMH capabilities the physician practices have in place – such as 24-hour telephone access, use of disease registries, and active care management.  The other one-half of the designation score was based on quality and utilization measurements, such as emergency room visits, radiology and evidence-based care measures among their patients.

Blue Cross has posted a list of PCMH designated physicians on its Web site at bcbsm.com. People interested in locating a PCMH physician in their community can go to bcbsm.com and click on "Find Doctor" at the top of the page.

The PCMH initiative is part of Value Partnerships, a collection of collaborative initiatives among physicians, hospitals and the Michigan Blues, all aimed at improving quality in medical care. To learn more about this comprehensive effort, go to www.valuepartnerships.com.

Blue Cross Blue Shield of Michigan is a nonprofit corporation and independent licensee of the Blue Cross and Blue Shield Association. For more company information, visit bcbsm.com.

SOURCE Blue Cross Blue Shield of Michigan

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