More than 4000 Physicians Now Designated Patient Centered Medical Homes by Blue Cross Blue Shield of Michigan

Some 4,022 primary care doctors, have been designated as patient-centered medical homes for the 2014 program year by Blue Cross Blue Shield of Michigan.

The doctors are members of 1,422 physician practices that combined care for more than 1.2 million BCBSM members in 78 of Michigan’s 83 counties.

The program, in its sixth year, continues to lead the nation in size and cost savings, BCBSM said.

The health plan said it recorded certified savings of $155 million in prevented ER and hospital claims from the first three years of the PCMH designation program.  Savings estimates for year four are expected later this year.

“Data from 2013-2014 shows adult patients in Blue-designated PCMH practices had a 27.5 percent lower rate of hospital stays for certain conditions than non-designated practices,” BCBM said.

“These are cases where appropriate care in a doctor’s office or clinic prevents a medical condition from worsening.”

——————————————————————————–
Guide to Physician Performance-Based Reimbursement: Payoffs from Incentives, Data Sharing and Clinical Integration

How healthcare organizations are constructing payment and compensation models that reward physicians for improving population health, the patient experience and per capita cost — approaches that may lure more medical residents back to primary care.

Guide to Physician Performance-Based Reimbursement: Payoffs from Incentives, Data Sharing and Clinical Integration 
——————————————————————————————-

PCMH practices also had an 8.7 percent lower rate of adult high-tech radiology use, and a 9.9 percent lower rate of adult ER visits over non-PCMH doctors, the health plan reported. Pediatric patients had a 14.9 percent lower rate of ER visits overall, and a 21.3 lower rate of ER visits expressly due to them receiving appropriate and timely in-office care.

The health insurer said an additional 2,600 Michigan primary care physicians are working toward the Blue PCMH designation by transforming how their practices deliver health care services to patients.

“The number of physicians earning yearly PCMH designation from BCBSM has more than tripled since BCBSM first launched the program in 2009, when 1,200 physicians were designated,” the payer said.

PCMH designation lasts for one year, July through June, the health plan said. Physician practices work to earn designation each year. Half of the designation score is based on a practice’s PCMH capabilities – such as 24-hour access for patients and test tracking.

The other half of the designation score is based on care quality and utilization measurements, such as number of emergency room visits among patients.

 

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

w

Connecting to %s