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More than 1,800 physicians receive PCMH designation for 2010
Blue Cross Blue Shield of Michigan has designated more than 1,800 Patient-Centered Medical Home physicians in about 500 practices across the state, securing its position as the largest such initiative in the nation.
This represents roughly a 50 percent increase over the number of physicians designated in 2009. Currently, the Blues' Patient-Centered Medical Home program impacts close to 2 million Michigan residents.
"The Michigan Blues and our physician partners are improving the primary care environment throughout the state by making changes to processes that affect all patients that come into their offices," said Thomas Simmer, M.D., BCBSM chief medical officer and senior vice president.
There are currently about 5,000 primary care doctors in the Physician Group Incentive Program who are working to transform their practices in line with the patient-centered medical home model. Simmer noted that while all of those doctors did not receive designation this year, their efforts are commendable.
"It takes hard work and a committed team of professionals to transform a practice according to PCMH principles," Simmer said. "Physicians have made extensive progress over the last year, as evidenced by the increase in designations from 1,200 in 2009 to 1,800 in 2010."
In the patient-centered medical home model, primary care physicians lead care teams that are focused on helping patients meet their individual health goals and needs. The teams work with patients to keep them healthy and monitor their care on an ongoing basis, using such tools as registries to track patients' conditions and ensure they receive the care they need.
The BCBSM Patient-Centered Medical Home program uses a model that considers both process of care and performance in the designation process. Half of the designation score was based on the amount of PCMH capabilities the 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 was based on quality and utilization measurements, such as emergency room use rate, radiology use rate and use of evidence-based care measures.
Additional compensation
Like last year, designated practices will receive an additional 10 percent payment from BCBSM for office visits. This recognizes physicians and care teams for spending extra time with patients during appointments, and extra time for care coordination and disease management.
This year, a benchmark group of PCMH-designated practices will receive an additional 10 percent on top of that, amounting to a 20 percent increase in office visit fee payments. This group represents the top 15 percent of designated practices that achieved benchmark performance on total cost or cost trend improvement.
The cost measurement was conducted in a separate analysis using specific, risk-adjusted criteria.
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