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+

130 million patients will receive accountable care by 2017

Accountable care organizations (ACOs) and value-based purchasing arrangements will be responsible for the care of 130 million patients by 2017, predicts a report by Parks Associates.  Accountable care will generate nearly $1 billion in revenue for healthcare providers in 2014 as they transform into ACOs and patient-centered medical homes (PCMH).
 
News Author: 
Jennifer Bresnick

Growth in Blues’ patient-centered medical home program shows statewide transformation of care

Our patient-centered medical home program has grown to 4,022 primary care doctors at 1,422 practices around the state in its sixth year of operation.These practices care for more than 1.2 million BCBSM members in 78 of Michigan’s 83 counties. The program continues to lead the nation in size and cost savings, helping to improve the quality and delivery of health care for all Michigan residents.

The growth in the program reflects significant momentum by physicians to bolster the primary care system, improve quality and make health care more effective and safer for patients.

News Author: 
Carly Getz

Understanding What Works: Improving Primary Care Physicians’ Performance for High-Cost, High-Need Patients

UMSI Assistant Professor Julia Adler-Milstein received a $344,298 grant from The Commonwealth Fund to support a two-year study of strategies and techniques that can improve primary care performance for high-cost, high-need patients.

Humana medical home program - Metro Health PHO

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

Humana medical home program - Henry Ford Health System

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

Humana medical home program - Borgess Health

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

Humana medical home program - Michigan Healthcare Professionals

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

Humana medical home program - Greater Macomb PHO

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

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