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.