BCBS South Carolina Patient-Centered Medical Home Program
Program Location:
Charleston, SC
Payer Type:
Commercial
Parent Program:
Payers:
Blue Cross Blue Shield South Carolina
Reported Outcomes
Description:
BlueCross BlueShield South Carolina is connecting physicians, nutritionists, care coordinators and even pharmacists ensuring that patients are provided with comprehensive care and a full understanding of their medications. BlueCross BlueShield of South Carolina has several Patient-Centered Medical Home (PCMH) practices in their network across the state.
Payment Model:
The patient-centered medical home compensation model is a blended payment methodology that recognizes infrastructure changes and enhanced patient services: Fee-for-service payment, including payments for some non-traditional services (e.g., electronic visits, pharmacist consultations). Per-member, per-month care coordination fee. Bonus adjustments to care coordination fee for quality outcomes.
Fewer ED / Hospital Visits:
- 36% fewer hospital days
- 12.4% fewer emergency department visits
- Hospital admission rates were 10 percent lower per 1,000 patients
Cost Savings:
- 6.5% reduction in total medical and pharmacy costs compared with controls
Last updated March 2019
