Columbia, S.C. — More than 800 diabetes patients are enjoying better health thanks to a coordinated approach to care sponsored by BlueCross BlueShield of South Carolina, BlueChoice® HealthPlan and Palmetto Primary Care Physicians.
That’s the outcome of a two-year study examining a centralized program called a patient-centered medical home. The approach focuses on primary care. It centralizes delivery of health services and links provider reimbursements with patient health outcomes.
The diabetes patients were members of BlueCross and of BlueChoice HealthPlan of South Carolina. Their health improved in the first year of the study and even more during the second year, which ended recently. They had 14.7 percent fewer inpatient hospital days and 25.9 percent fewer emergency room visits. They had better control of their blood pressure, cholesterol and glucose levels. They also had healthier body mass index (BMI) rates, and more of them received eye exams.
In a patient-centered medical home, patients are cared for by a primary care physician who leads a full medical team. The team coordinates all aspects of patient care, from preventive and acute care to managing chronic health needs. BlueCross and BlueChoice HealthPlan changed their pay models to include a per member, per month fee and a bonus for improved health results, in addition to the typical fee-for-service claims. Palmetto Primary Care Physicians hired care coordinators specifically for this group of patients. The care coordinators contacted patients regularly and helped them through the complexities of the health care system.
“We changed our pay model and Palmetto Primary Care Physicians changed their delivery model. Under this arrangement, our members made even greater strides in managing their conditions in the second year, thanks to the addition of care managers and a team effort centered on the patient,” said Dr. Laura Long, BlueCross’ vice president of clinical quality and health management. “This reinforces our belief that patient-centered medical homes are the front line to better outcomes, better health and lower costs for our members.”
This patient-centered medical home was BlueCross’ first in the state. BlueCross has since established patient-centered medical homes for heart failure patients with primary care practices at the University of South Carolina Family Medicine practice in Columbia and Mackey Family Practice in Lancaster. BlueCross is expanding the model to other locations in South Carolina. In addition to diabetes, some programs will focus on hypertension, or high blood pressure.
Charleston-based Palmetto Primary Care Physicians has 26 sites in Charleston, Berkeley and Dorchester counties.
Headquartered in Columbia, S.C., and operating in South Carolina for nearly 65 years, BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina (www.BlueChoiceSC.com) are independent licensees of the Blue Cross and Blue Shield Association. The only South Carolina-owned and operated health insurance carrier, BlueCross BlueShield of South Carolina comprises more than 45 companies involved in health insurance services, U.S. DoD health program and Medicare contracts, other insurance and employee benefits services, and a philanthropic foundation that funds programs to improve health care and access to health care for South Carolinians.