Blue Cross Blue Shield of Michigan designates local physician practices as patient-centered medical homes

Blue Cross Blue Shield of Michigan has designated five Saint Joseph County practices as patient-centered medical homes for the 2015 program year – meaning they have particular qualities and processes that help improve health care quality and outcomes by maintaining a coordinated, team focus on their patients’ health and wellness. Designated practices include:

· Colon Medical Clinic

· Bharat M. Vakharia, MD PC

· SMG Physician Offices

· Sturgis Pediatrics

· ProMed Family Practice Three Rivers

Statewide, Blue Cross designated 1,551 primary care practices as patient-centered medical homes, encompassing more than 4,340 physicians.

The designated practices are recognized for intensified efforts to coordinate patients’ health care through prevention, diagnosis, treatment and follow-up services. Thanks to the Blue Cross program, doctors can better monitor their patients’ conditions, coordinate care with specialists and ensure people are getting the right care, at the right time, in the right setting.

“Through our efforts on the Patient-Centered Medical Home, Blue Cross is demonstrating that ongoing collaboration between insurers, physicians and patients can lead to higher quality care and lower costs,” said Daniel J. Loepp, Blue Cross Blue Shield of Michigan president and CEO. “The medical home is health care reform in action – it’s improving lives, improving care and lowering costs.”

Recognized by awards from health and insurance organizations nationally, the Blue Cross Patient-Centered Medical Home program has saved an estimated $512 million over six years through disease prevention, reduced hospitalizations and emergency room visits, and management of common acute and chronic medical conditions that have improved patient care outcomes.

“Our program exemplifies what patient-centered care means. It means stronger connections between doctors and patients. People avoiding emergency care because they can connect with their doctor around the clock. And people leading better lives because their doctor’s team is working hands-on with them to manage chronic conditions,” said David Share, M.D., M.P.H., senior vice president, Value Partnerships, Blue Cross Blue Shield of Michigan.

Data from 2015 show that Blue Cross PCMH-designated practices have patients who require fewer hospital admissions and emergency room visits than patients in non-designated practices.

For example, adult patients in designated PCMH practices had a 26 percent lower rate of hospital admissions for common conditions that respond to office-based care.

Blue Cross-designated PCMH practices also had an 8.7 percent lower rate of adult high-tech radiology use, and a 10.9 percent lower rate of adult ER visits. PCMH practices had a 16.3 percent lower rate of pediatric ER visits, and a 22.4 lower rate of pediatric ER visits for common chronic and acute conditions such as asthma.

“Our Patient-Centered Medical Home program provides a stronger base of primary care services for Michigan residents,” Share said. “Now we are building on that foundation by working with specialists, hospitals and other care providers to help them collaborate to form Organized Systems of Care. These systems manage the health of a group of patients by coordinating patient care across all settings.”

The Blue Cross Patient-Centered Medical Home Program touches roughly 1.25 million Blue Cross members who visit designated practices. However, the benefits of improved care extend to all patients visiting these offices, not just Blue Cross-insured patients.

The number of physicians earning PCMH designation from Blue Cross Blue Shield of Michigan has increased each year since the program launched in 2009, with 1,200 designated physicians. Designation extends for one year, July 1 through June 30. Physician practices work to earn designation each year. This year, 91 percent of practices designated in 2014 were re-designated.

To search online for a Blue Cross PCMH-designated physician, Blue Cross Blue Shield of Michigan and Blue Care Network members can visit bcbsm.com and click on Find a Doctor.

The PCMH initiative is part of Value Partnerships, an array of collaborative initiatives among physicians, hospitals and Blue Cross, aimed at improving quality and outcomes in medical care. To learn more about these programs, visit valuepartnerships.com.

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