BCBS RI Patient Centered Medical Homes
Program Location:
Providence, RI
Number of Practices:
39
Payer Type:
Commercial
Parent Program:
Payers:
Blue Cross Blue Shield Rhode Island
Reported Outcomes
Description:
Blue Cross & Blue Shield of Rhode Island (BCBSRI) is working with primary care practices in Rhode Island to help improve patient/member "experience of care" while empowering them to be actively involved in their care plan; improve quality of healthcare in a population of patients; support the primary care infrastructure in Rhode Island; maximize skills of all members of the care team to provide the most efficient care to patients; and create lower overall costs (i.e., "waste" management) through improved coordination of care with electronic health records
Related News & Resources
Fewer ED / Hospital Visits:
BCBS Rhode Island Press Release (2015) evaluated more than 89,000 commercial and 14,000 Medicare Advantage members within BCBSRI’s PCMH over the 2009 – 2014 time period
- patients with complex medical conditions, like diabetes or cardiac health issues, are 16 percent less likely to be hospitalized or need to visit an emergency department (vs. comparison practices)
- readmissions to hospitals were 30 percent lower among this population (vs. comparison practices)
Improved Health:
BCBS Rhode Island Press Release (2015) evaluated more than 89,000 commercial and 14,000 Medicare Advantage members within BCBSRI’s PCMH over the 2009 – 2014 time period
- patients at PCMH practices saw marked improvements in a range of quality measures including diabetes care and colorectal screening.
BCBS Industry Report (2011)
Improved quality of care measures with a median rate of improvement of:
- 44% for family and children’s health
- 35% for women’s care
- 24% for internal medicine
Cost Savings:
BCBS Rhode Island Press Release (2015) evaluated more than 89,000 commercial and 14,000 Medicare Advantage members within BCBSRI’s PCMH over the 2009 – 2014 time period
- Return on investment in the PCMH program was more than 250 percent
Data Source(s):
Last updated November 2015
