Patient centered medical homes (PCMHs) are the focus of this article, highlighting that the PCMH model has resulted in “improved patient outcomes, lowered payer costs and increased provider satisfaction and revenue.” Focusing on the PCMH program at Blue Cross Blue Shield of Michigan, three key factors can contribute to the success of PCHM programs: partnerships with physicians; program flexibility; and broad network reach.
A recent study on the Blue Cross Blue Shield of Michigan program reports that “providers who adopted the PCMH model have reduced emergency department visits by 3.7 percent and inpatient hospitalizations by 3.8 percent.” This not only benefits consumers, but also payers as the program showed “network cost-reductions of 17.2 percent for hospital visits, with emergency department costs down 9.4 percent for patients with the six most common chronic conditions.” Providers also benefit by earning “anywhere from 10 to 40 percent in additional value-based reimbursement, depending on their performance on quality and care management measures.”
Delaware’s goal is for every Delawarean to have a primary care provider who will serve as a “linchpin” for all of the patient’s health care, uniting accountability for quality and cost across all providers. Find out how DCHI is transforming health care practices across the state, ensuring they are more integrated, team-based, and patient-focused, by visiting http://www.dehealthinnovation.org/.
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