PGIP Physician Organizations Leverage Patient-Centered Medical Home Concepts to Maintain Patient Care During COVID-19 Pandemic

Debbie Reinheimer

| 3 min read

Dad taking his daughter's temperature talking to a doctor online
COVID-19 hit hard in Michigan in early 2020. So many people were infected with the virus that physician offices closed to in-person appointments to help contain the spread. Physician offices needed to swiftly transition to virtual appointments and find alternate ways for their patients to receive necessary care. For MedNetOne Health Solutions (MedNetOne), a PGIP-participating physician organization based in Rochester, Michigan, the principles behind the patient-centered medical home model offered a framework that enabled them to support their physician practices in providing uninterrupted care during the closures. “When the pandemic hit, no one expected it to have such an impact, or expected it to last so long,” said Ewa Matuszewski, MedNetOne CEO. “But we quickly realized our PCMH care teams would be crucial in supporting doctor offices and patients while routines were disrupted from the coronavirus crisis.” For example, when PCMH practices had patients who tested positive for COVID-19, MedNetOne care teams reached out to the patients and their families to offer follow-up care. They also created care packages for each family, filled with masks, gloves, hand sanitizer, a pulse oximeter and other comfort items. Electronic medical records and the state’s health information alert system also were essential. Information connectivity is a key component of the patient-centered medical home model. “We were able to keep track of the patients who were COVID-positive and quickly activate follow-up support,” said Matuszewski. “We were alerted to which patients were admitted to a hospital, discharged home, or which patients went to the ED. We also received lab results.” But Matuszewski says the PCMH model’s biggest benefit during the coronavirus crisis has been its focus on patient communication. “Our PCMH practices have procedures in place for how they communicate with and engage patients. They were already sending reminders and reaching out to patients who needed tests or appointments. They simply continued this process, and many saw patients through telehealth services,” said Matuszewski. This year, 4,644 primary care physicians in nearly 1,700 practices across 80 counties in Michigan earned Blue Cross PCMH designation. These practices care for nearly 3 million Blue Cross members. PCMH practices, compared to non-PCMH practices, have lower rates of inpatient hospital stays and emergency department visits. Care coordination and patient follow-up are key reasons behind this. Patients are getting the care they need from their PCMH practice, which prevents situations from getting to the point where higher levels of care are necessary. To find a PCMH primary care physician, go to “Advanced Search” in the Find a Doctor section on and select Patient-Centered Medical Home under “Quality Reports.” Related:
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