BCBSM designates 770 medical homes

July 15, 2011

Blue Cross Blue Shield of Michigan (BCBSM) has designated roughly 2,500 physicians in 770 practices across the state as patient-centered medical homes (PCMH), a 28% increase from the 1,800 designated PCMH physicians in 2010.

Blue Cross Blue Shield of Michigan (BCBSM) has designated roughly 2,500 physicians in 770 practices across the state as patient-centered medical homes (PCMH), a 28% increase from the 1,800 designated PCMH physicians in 2010. BCBSM says it has built the nation’s largest patient-centered medical home program.

More than 5,000 primary care doctors in Michigan are working toward designation as PCMH practices, according to BCBSM.

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

In comparing utilization trends of PCMH-designated and non-designated physicians, BCBSM has observed that PCMH-designated doctors are succeeding in managing their patients’ care to keep them healthy and prevent complications that require treatment with expensive medical services. For example in 2010, PCMH practices had an 11.1% lower rate of adult ambulatory care sensitive inpatient admissions than non-designated practices; a 6.3% lower rate of adult high-tech radiology usage; a 6.6% lower rate of adult emergency room visits; a 3.3% higher rate of dispensing generic drugs; and a 7% lower rate of adult ambulatory care sensitive ER visits over non-PCMH doctors.