DorlandHealth

By Richard Scott

The medical home has taken another giant step forward. Blue Cross Blue Shield of Michigan has expanded the patient-centered medical home (PCMH) into 500 physician practices involving more than 1,800 physicians across the state.

The effort, which is the largest in the nation, directly impacts the practice of case management. When considering which physicians to designate as medical homes, one of BCBS’ defining criteria is identified as “active care management.” And as case managers know, one of the principles of the medical home is the coordination of care across channels, from primary care to specialty care, for example, or from a hospital to a long-term care facility.

In total, almost 5,000 primary care physicians are pursuing a PCMH designation in Michigan. The movement stems from a coordinated effort between physicians, hospitals and the insurer, BCBS, and its collaborative care paradigm is changing the face of care delivery. In the PCMH model, patients are monitored on an ongoing basis, and self-management is critical. Health IT also plays an important role. In fact, as a defining principle of PCMH, health IT is paramount to the program’s success. For instance, a team member such as a case manager will track a patient’s progress using a registry that gives an overarching view into the patient’s course and needs.

“People want closer relationships with their doctors, not only when they are sick, but when they need advice and guidance to keep them healthy,” said Dr. Thomas Simmer, vice president and chief medical officer of BCBS Michigan.

Studies have shown that the PCMH has delivered improved patient outcomes, a more controlled utilization of resources and better practitioner and patient satisfaction. Stressing a team model, PCMH offers an emerging paradigm for case managers. And as the developments in Michigan show it is only getting bigger.
 

Are you new to the PCMH? Watch a video from the Patient-Centered Primary Care Collaborative to find out more on how it works. To read about NCQA’s medical home standards, click here. Are you involved with a medical home? Email Managing Editor Richard Scott to share your experience with the case management community.