BCBS Tennessee Patient-Centered Medical Home

BlueCross BlueShield of Tennessee is championing the PCMH program for their members by providing additional funding for health information technology, as well as an on-site care coordinator who engages in proactive outreach to patients and the community. Several million dollars will be reallocated and invested across the state to enable practices to provide personalized care. These resources redistribute funding to primary care practices and assist them in managing in a much more coordinated fashion those patients with chronic conditions such as heart disease, chronic lung disease and diabetes. Additionally, BlueCross will reward the practices based on quality and effectiveness.

The PCMH program allows chronic condition members to receive greater medical access and personalized attention through their primary care physician. This access can be same day appointments, telephonic consultations, extended hours or other options for the patients. A confidential, secure patient online service is also available at some practices to give patients quick and convenient access to both their medical information and their personal doctor. Personal health coaching is also provided. This enhanced access allows the patient to better manage their health care conditions and concerns, yielding positive outcomes such as decreasing per-person health care costs, reducing emergency room visits and declining hospital admission trends.

The current PCMH programs focus on managing chronic conditions, which the Centers for Disease Control and Prevention estimate account for 75 percent of the nation’s total health care costs. The conditions currently being focused on by the PCMH program include diabetes, asthma, congestive heart failure, hypertension, coronary heart disease and chronic obstructive pulmonary disease.