S.C. BlueCross Patients At Lancaster Medical Practice Improve Health Under New Model
April 30, 2012
COLUMBIA – BlueCross BlueShield of South Carolina members of a patient-centered medical home (PCMH) at Mackey Family Practice in Lancaster and Indian Land, S.C., improved their health and had fewer hospital admissions and emergency room visits during the first year of the new health care model.
A PCMH puts the primary care provider in charge of coordinating all services. Those include checkups, tests, support, referrals to other providers, and follow-up for urgent care, emergency services and hospitalizations. The goal is to ensure that all of the patients’ problems are addressed in a timely, cost-effective, professional manner and none of their needs fall through the cracks.
The model at Mackey Family Medicine was open to patients who have diabetes and are members of BlueCross plans as well as BlueChoice HealthPlan of South Carolina and the State Health Plan.
After the first year, participants had improved their health in eight of 10 measures, including weight, blood pressure and glucose levels. They also documented fewer emergency room visits and hospital admissions than in the previous year, as well as when compared to non-PCMH patients with diabetes in Kershaw and Lancaster counties.
BlueCross and BlueChoice HealthPlan provided support - beyond just paying claims - for Mackey to provide case management, patient education materials, and other care coordination and quality improvement resources and activities.
“We congratulate our patients for participating in this PCMH and working to improve their health. We believe this approach is a great model for helping them do that. It replaces episodic care based on patient illness and complaints, with coordinated care and a long-term relationship,” said Keith Shealy, M.D., president at Mackey Family Practice.
Laura Long, M.D., MPH, and BlueCross’ vice president of clinical innovation and population health, said: “This is the third patient-centered medical home we have supported that has reported improved health outcomes and better use of the medical system. Collaboration in a new pay and delivery model such as this is fundamental to improving health care.”
BlueCross and BlueChoice HealthPlan are the only insurance companies supporting or assisting practices adopting the PCMH model in South Carolina. This is one of many BlueCross initiatives that rely on collaboration with physicians, hospitals and its customers to achieve the Triple Aim of improved outcomes, reduced cost and enhanced patient experience.
Mackey Family Practice (www.mackeyfamilypractice.com), which serves Lancaster and surrounding counties, has five physicians and one nurse practitioner covering two office locations. The practice integrated behavioral health in its PCMH by having a licensed counselor on site for consultations on conditions such as depression. The PCMH is now entering its second year and has added patients diagnosed with hypertension (high blood pressure).
About BlueCross BlueShield of South Carolina
Headquartered in Columbia, S.C., and operating in South Carolina for more than 65 years, BlueCross BlueShield of South Carolina (www.SouthCarolinaBlues.com) is an independent licensee of the Blue Cross and Blue Shield Association. The only South Carolina-owned and operated health insurance carrier, BlueCross BlueShield of South Carolina comprises 47 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. BlueChoice HealthPlan of South Carolina also is an independent licensee of the Blue Cross and Blue Shield Association.
The Blue Cross and Blue Shield Association is a national federation of 37 independent, community-based and locally-operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for nearly 105 million members – one-in-three Americans. For more information on the Blue Cross and Blue Shield Association and its member companies, please visit bcbs.com. We encourage you to connect with us on Facebook, check out our videos on YouTube, follow us on Twitter and check out The BCBS Blog, for up-to-date information about BCBSA.