Mich. Blues adds more docs to nation's largest medical home program

Now in its fifth year, Blue Cross and Blue Shield of Michigan's patient-centered medical home program has certified 3,770 physicians in 1,243 practices for 2013, a 25% increase in physicians from 2012.

As the nation's largest medical home program, Blue Cross provides financial incentives to primary care physicians to work more closely with patients and specialty doctors to improve their health and monitor their care.

Medical home physicians continue to reduce unnecessary patient admissions, emergency department visits, and imaging procedures, and are dispensing more generic drugs than brand names, said David Share, M.D., Blue Cross' senior associate medical director of quality.

"In Blue Cross' program, each patient has his or her own healthcare team. The team works together, in partnership with the patient, to focus on each patient's personal goals and needs," Share said in a statement.

"Physicians and their care teams are improving patient outcomes, which leads to lower costs because there is less need for testing and hospital care."

Medical home practices offer a variety of services to their patients. They include evening and weekend appointments, nutritional counseling, home care links to community services and care coordination with specialty physicians. Medical home physicians also use a disease registry or electronic medical record system to track patient care.

More than 1.1 million Blue Cross enrollees and nearly 2 million patients in Michigan have access to Blue Cross medical home physicians.

"We are seeing continued growth because there are a lot of practices waiting in the wings to develop medical home capabilities," said Share. Another 1,000 physicians are taking steps to become certified as medical home providers.

During the first three years of the program, Blue Cross recently documented that medical home physicians avoided $155 million in costs to Blue Cross and patients.

Share said Blue Cross medical home practices have lower rates of hospitalizations and emergency department use than other physicians. In 2013 for example, Blue Cross found:

  • A 19.1 percent lower rate of adult hospital discharges for certain "ambulatory care sensitive" conditions that include gastroenteritis, angina, pneumonia, asthma, congestive heart failure, hypertension and diabetes.

  • An 8.8 percent lower rate of emergency department visits.

  • A 7.3 percent lower rate of adult high-tech radiology usage than other non-designated primary care physicians.

    For children under age 17, a 17.7 percent lower rate of ER visits.

Several other health insurers also sponsor medical home programs. They include Detroit-based Health Alliance Plan of Michigan and Priority Health, which has an office in Farmington Hills.

"Blue Cross adds more physicians to nation's largest medical home program" originally appeared in Crain's Detroit Business.



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