Michigan

The Michigan Primary Care Transformation Project (MiPCT) is one of the oldest and longest-running multi-payer initiatives for patient-centered medical homes (PCMH). It was developed in 2010 as a multi-payer initiative to test the value of the PCMH model of care.  In July 2013, Blue Cross Blue Shield of Michigan, the largest commercial payer in the program, reported savings of $155 million over the first three years of the program. Building on this success Michigan has made plans to expand their network of PCMH's as the foundation for their statewide health care improvement efforts. In January 2014, the Michigan Governor's Office submitted the Blueprint for Health Innovation, Michigan's State Health Care Innovation Plan.  The six foundation components for the Blueprint include:

  • Patient-centered medical homes 
  • Provide care coordination to improve health care outcomes for individauls requiring intensive support services
  • Community health innovation regions to improve population health
  • Improve systems of care
  • System improvements to reduce administrative complexity
  • Contain health care costs and shift to value-based payment models

The Blueprint proposes to develop Accountable Systems of Care comprised of medical homes, specialists and hospitals with the capacity to integrate clinical care across settings. On December 30, 2013, CMS granted approval for Michigan to amend its Healthy Michigan 1115 demonstration waiver to implement Medicaid expansion to all adults with incomes up to and including 138% of the Federal Poverty Level beginning on April 1, 2014.  

CHIPRA: 
No
MAPCP: 
Yes
Dual Eligible: 
Yes
2703 Health Home: 
Yes
CPCi: 
Yes
SIM Awards: 
Yes
PCMH in QHP: 
No
Legislative PCMH Initiative: 
No
Private Payer Program: 
Yes
State Facts: 
Population:
9,848,100
Uninsured Population:
11%
Total Medicaid Spending FY 2013: 
$12.4 Billion 
Overweight/Obese Adults:
66.2%
Poor Mental Health among Adults: 
35.9%
Medicaid Expansion: 
Yes 
CPC+: 
CPC+

Cancer screening rates improve, disparities shrink for patients with Blue Cross Blue Shield of Michigan patient-centered medical home doctor

PCMH model particularly improved rates for patients in at-risk populations

 A new study published last month in JAMA Internal Medicine shows Blue Cross Blue Shield of Michigan's Patient-Centered Medical Home model improved overall cancer screening rates for colon, breast and cervical cancer. 

Incentive Payments Lead to Healthier Patients, Say Michigan FPs

Incentive payments for physicians who treat Medicare and Medicaid patients have been generating a lot of interest among policymakers lately, but one private insurer in Michigan has been offering performance-based primary care bonuses for several years.

In 2009, Blue Cross Blue Shield of Michigan began offering what it calls "tiered" payments for primary care. Primary care physicians under contract with the insurer can receive incentive payments ranging from 10 percent to 30 percent or more if they reach specific performance targets.

News Author: 
Michael Laff

A steady doctor for babies to call their own

Inside a converted fruit warehouse near the Grand River in Grand Rapids sit several specialists on the front lines of ensuring that young children get a healthy start in life. 

They work for Health Net of West Michigan, a nonprofit community healthcare hub that connects families with doctors and other community services in the Grand Rapids area. One of Health Net's primary tasks seems simple at first glance - making sure low-income children have a primary care physician.

News Author: 
Bill McGraw

Many Michigan ACOs saving millions under Medicare's cost-saving plan

Many of the 15 accountable care organizations in Michigan are saving millions of dollars for the Medicare program along with passing along significant financial rewards to hundreds of participating physicians, according to several local ACO executives. 

Under Medicare's ACO cost containment program — begun as three-year pilot projects outlined in the Affordable Care Act of 2010 — groups of hospitals, physicians and other providers band together to coordinate care for seniors enrolled in traditional Medicare. 

News Author: 
Jay Greene

Blue Cross starts health system payouts for value-based contracts

The first payouts totaling $25 million have been made to five health care systems in Michigan that signed innovative, value-based reimbursement contracts with Blue Cross Blue Shield of Michigan in 2011 and 2012.

Since five-hospital St. John Providence Health System in Warren signed the first value-based contract with the Blues in 2011, 17 other health systems and a total of 71 hospitals in Michigan are participating under various starting dates and terms.

News Author: 
Jay Greene

Gateway to Health: An Innovative Model for Primary Care Expansion in Detroit

The award will enable the Detroit Medical Center (DMC) to test an innovative primary care and preventative health model that reaches patients who use some of Detroit’s busiest emergency departments. 

Altarum Institute's reducing childhood dental disease program

Altarum Institute received an award of $9.4 million from the Center for Medicare & Medicaid Innovation (CMMI) to reduce the burden of childhood dental disease in Michigan. The award is focused on children aged 0–17 enrolled in Medicaid or the Children’s Health Insurance Program. Combined, these two insurance programs cover nearly half of Michigan’s children.

Medicaid in an Era of Change: Findings from the Annual Kaiser 50-State Medicaid Budget Survey at a Forum with the National Association of Medicaid Directors

2014-10-14 09:30 to 11:30

State Medicaid programs are in a time of transformation as the implementation of the Affordable Care Act, the focus on delivery system reforms and the improving economy drive changes in Medicaid’s coverage and provision of health and long term services and supports, with varied impacts on Medicaid spending and enrollment around the country.

Announcement Type: 

Bill to Expand Access to Direct Primary Care Services in MI Passes Senate Committee

Michigan launched the first retaliatory salvo against the so-called Affordable Care Act (Obamacare) this week as legislation sponsored by Senator Patrick Colbeck(R-Canton) to assert that Direct Primary Care Services should not treated as an insurance product was reported out of the Senate Insurance Committee. The purpose of the bill (SB 1033) is to assure physicians who convert their practice to a Direct Primary Care Service model that the administrative burden associated with insurance regulations will not interfere with their treatment of patients.

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