Blue Cross Blue Shield of Michigan Opens PCMH Program to Specialists

Collaborations among physicians, healthcare providers, and Blue Cross Blue Shield of Michigan (Detroit) continue to grow, as the insurer opened its Physician Group Incentive Program to all specialists this summer to prepare for additional healthcare improvement initiatives for Michigan residents.

Since 2005, the PGIP program has encouraged primary care physicians and those specialists who care for patients with common chronic illnesses to deliver quality, cost-effective care to patients. The Patient-Centered Medical Home Program, which improves the way primary care physicians partner with their patients to improve their health, is part of PGIP. With specialists, including podiatrists and chiropractors, on board, physicians will work together to develop and use shared information systems and processes of care, as well as sharing responsibility for the health outcomes of a group of patients. This marks the beginning of the Blues’ Organized Systems of Care Program—its version of the accountable care organizations that are included in the national Affordable Care Act’s Medicare Shared Savings program effective January 2012.

In this early stage of Organized Systems of Care development, about 5,330 physicians in 39 groups have expressed interest in participating in BCBSM’s OSC program. In July 2011, BCBSM launched two specific initiatives designed to help build OSC infrastructure, including a systemwide integration of patient registries and the tracking and reporting of performance measures such as patient health outcomes.