In July 2009, Blue Cross Blue Shield of Michigan (BCBSMI) selected doctors to participate in its patient-centered medical home project. Across Michigan, more than 1,800 primary-care providers at more than 500 locations have been participating in the project, making it the largest medical home program in the country. Twelve months later, the initial data from the project demonstrate positive impact on costs and emergency room utilization.
When compared to medical practices that are not participating in the project, but that are working toward becoming medical homes, emergency room use by adults is 1.4 percent lower for patients and hospital admissions are 2.6 percent lower for individuals whose doctors are participating in the project. Positive outcomes have been seen on the pediatric side as well, with emergency room visits 2.2 percent less frequent among patient-centered medical home participants.
BCBSMI envisions building on these gains to create more cost savings and increased efficiencies in care delivery. Much of the savings realized to date are being re-invested in the project, to support the continued implementation of patient-centered medical home components in existing and additional provider practices.
The health plan has made a considerable investment in this project, recognizing that instituting the necessary practice changes to become a medical home is a costly process for providers. The Michigan Blues allocated almost $30 million to providers working to become patient-centered medical homes, and will continue their investment in the project over the coming 12 months, dedicating “approximately $18 million in fees to doctors whose practices are designated as medical homes to cover costs of transforming the business, plus another $40 million to $50 million in reward payments for doctors who initiate practices such as e-prescribing and extending office hours to expand patient access to primary care.”*
According to Thomas Simmer, Blue Cross Blue Shield Senior Vice President and Chief Medical Officer, several key insights from the project to date are:
- Physicians participating in the project have changed the way they deliver care, and improved their performance;
- Health information technology is an element that makes it easier to perform as a patient-centered medical home;
- The process of becoming a patient-centered medical home takes time; and
- Patient-centered medical homes are a part of the solution, but are not the solution on their own.
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