This Model of Health Care has Changed Michigan for the Better

Deborah Reinheimer

| 3 min read

A lot can happen in eight years. Particularly in Michigan, where the last eight years have seen a rebirth of the economy and new businesses sprouting across the state. But there’s been another positive change in Michigan over the last eight years, and you’ll find it in your doctor’s office. It’s a model of health care called the patient-centered medical home, or PCMH. No, it’s not a house, not a nursing home. It’s actually a way of providing health care that is completely focused on each patient’s unique needs. And over the last eight years, Blue Cross-designated physicians using this PCMH model of care have kept members healthier and prevented $427 million in ER visits and hospital admissions. So what makes the Blue Cross patient-centered medical home model of care different? First, it’s team-based care, focused on you. That means you have a team of health care professionals, led by your primary care physician, who track your care, organize your test results, and work with you to set and meet your health goals. Not some random goals that “everyone” is supposed to meet. YOUR goals. Second, your PCMH team has extended access. They may be open late, or early, or on weekends. Or they have a 24-hour phone line, so you can call in the middle of the night and talk with someone who understands your health history. And because they have your health history, they can tell you whether something really is an emergency, or can wait until morning. Third, your PCMH team will coordinate your care, including things that may be affecting your overall state of health. For example, your PCMH team can connect you to exercise classes, nutrition counselors, mental health counselors, food banks, transportation services, or other community supports that will help you in your overall health. All of these qualities of the PCMH model of care have helped Blue Cross members better manage their health. Patients in PCMH practices get the care they need in the right setting, before conditions escalate. For example, adult patients in Blue-designated PCMH practices had a 21.4 percent lower rate of hospital admissions for certain conditions than non-designated practices. Blue Cross-designated PCMH practices also had a 15.1 percent lower rate of adult ER visits and a 17.2 percent lower rate of pediatric ER visits. Eight years ago, Blue Cross Blue Shield of Michigan issued the first designations to 1,200 primary care physicians who had made the most progress in transforming their practices to have the capabilities of a patient-centered medical home. The number of physicians earning PCMH designation has grown each year since, and in 2016, 4,534 primary care physicians in 1,638 practices across the state have earned this designation. Not only have the number of practices grown, but studies also indicate the positive impact on Michigan cost, quality and utilization of health care services. In 2016, there are Blue Cross-designated PCMH doctors in 80 of Michigan’s 83 counties. So wherever you live in Michigan, you most likely have close access to this model of care. A lot can happen in eight years. In Michigan, the primary care landscape has changed for the better. Make sure you’re taking part. You can find a PCMH-designated doctor by using the “Find a Doctor” tool on and selecting “PCMH Certified” in the search criteria. Photo credit:
MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association