Patient Centered Medical Home Case Study

In 2009, Blue Cross Blue Shield of Michigan (BCBSM) and its physician partners embarked on the nation’s largest patient-centered medical home (PCMH) designation program. The major goals of the program are to better manage patient care, reduce unnecessary tests, avoid unneccesary hospital admissions, and avoid emergency department visits. The project focuses on four areas of patient-centered medical home practices: care management, self-management support, care coordination, and linkage to community services.
Population
Blue Cross Blue Shield of Michigan’s patient centered medical home program is one of the largest in the nation. Consequently, BCBSM 's patient-centered medical home program can positively affect close to 2 million Michigan residents. The program 's size and success has already attracted national attention. Adults, children, and older adults with an array of conditions and/or …show more content…
Thus, allowing them to spend more time with patients to keep them healthy, or to better manage a chronic condition. Providers are given incentives to make the system changes that reduce hospitalization and improve quality outcomes. According to Berenson & Rich (2010), customization of reimbursement options, such as capitation fee-for-service hybrids, in individual sites based on the unique needs and characteristics of individual practices appear to be necessary, and monetary distribution plans among home participants will require negotiation. Accordingly, providers will share in cost savings under the BCBSM medical home model will come in decreased redundant tests, decreased medical errors, decreased emergency department visits, decreased hospitalizations, and prevention of costly complications. Furthermore, additional reimbursements are given to providers and staff who justly eliminate wasteful utilization