BCBS of Michigan Saves $155M from Patient Centered Medical Home Program

Blue Cross Blue Shield of Michigan saved an estimated $155 million in preventative claim costs over the first three years of its Patient Centered Medical Home program, according to analysis published in the Health Services Research Journal.

The analysis finds that when physicians adopt the patient centered medical home model it yields improvements in higher quality and preventative care. BCBS of Michigan is the nation’s largest Patient-Centered Medical Home designation program over the past five years.

According to the analysis, “Partial and Incremental PCMH Practice Transformation: Implications for Quality and Costs,” researchers found that its Patient Centered Medical Home model, when fully implemented resulted in:

  • 3.5 percent higher quality measure
  • 5.1 percent higher preventive care measure
  • $26.37 lower per member per month medical cost for adults

Is the Patient Centered Medical Home the Future of Primary CareThrough patient-centered medical homes, primary care physicians lead teams that proactively manage their patients’ care across health care settings — focusing on wellness, disease management and patients’ unique personal health goals. For example, PCMH practices offer 24-hour access to the care team and coordinate specialist and other care, such as nutrition counseling. PCMH practices also track patient conditions, such as asthma and diabetes, teach patients how to manage these conditions and connect patients to community services when needed.

Related: Is the Patient Centered Medical Home The Future of Primary Care? 

Highly optimized PCMH-based practices can earn even higher cost savings. In fact, the Michigan Blues estimate they may have saved an additional $155 million in the program’s fourth year.

“Through the Patient-Centered Medical Home model, doctors and their care teams are improving patient outcomes, which translates to fewer hospital admissions and emergency room visits, which leads to lower overall cost,” said David Share, M.D., MPH, BCBSM senior vice president, Value Partnerships.

Background

The research was funded by the national Agency for Healthcare Research and Quality. Blue Cross Blue Shield of Michigan began collaborating with physicians across Michigan in 2005 to study and test what key features and capabilities should be included in a Patient-Centered Medical Home model with physician practices earning designation starting in 2009.

Practices earning designation were found to have made the most progress in transforming their processes, staff and procedures into the PCMH care model. The Blues’ Patient-Centered Medical Home program improves care for approximately 1 million Blue Cross members and 2 million Michigan residents because the practices follow the PCMH approach for their entire patient populations.

The PCMH initiative is part of Value Partnerships, a collection of collaborative initiatives among physicians, hospitals and the Michigan Blues, all aimed at improving quality in medical care. To learn more about this comprehensive effort, go to valuepartnerships.com.

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