Hundreds of docs join med homes

June 27, 2010
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Blue Cross Blue Shield of Michigan has designated 431 doctors in West Michigan’s four largest counties to its roster of patient-centered medical homes.

The largest insurer in the state is working with Michigan’s approximately 5,000 primary care doctors to alter their practices to meet its PCHM standards, said Dr. Thomas L. Simmer, BCBSM’s senior vice president and chief medical officer.

BCBSM offers higher reimbursements for those who have put the PCMH model into place. Enhanced BCBSM payments are effective July 1.

Six-hundred doctors were added to the 1,200 designated last year, bringing the total in the program to 1,800, which represents some 500 practices.

That includes 233 in Kent County, 67 in Ottawa County, 69 in Kalamazoo County and 62 in Muskegon County.

“It’s not just a cost-cutting goal,” Simmer recently told the Business Journal. “It is to be more proactive — respect the patient’s role in taking care of themselves with the support and facilitation of the health care team. That is a very exciting and transformational change that leads to better outcomes, and that’s how you save the money.”

Metrics include such features as 24-hour telephone access, use of disease registries, care coordination by a team of health professionals, and education on management of chronic diseases such as asthma and diabetes. The doctors also were rated on quality and utilization, such as emergency room visits, radiology use and how well they meet evidence-based care measures.

The changes represent investments — financial, as well as in personnel and time — for physicians, Simmer added.

More information is available at www.valuepartnerships.com

A list of doctors added in the four West Michigan counties is available at www.grbj.com

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