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Patient-Centered Medical Home (PCMH)

The Blue Cross and Blue Shield Association (BCBSA) and participating Blue Cross and Blue Shield (BCBS) companies are working in collaboration with national and local industry stakeholders to enhance the practice and delivery of primary care. The Patient-Centered Medical Home (PCMH) places the patient and primary care practice at the center of care and creates a healthcare setting that is a collaborative partnership between the patient and their personal physician.

What is the PCMH

The PCMH is a model of healthcare based on an ongoing, personal relationship between a patient, doctor and the patient's care team.  Whatever the medical needs – primary or secondary, preventive care, acute care, chronic care, or end-of-life care – the patient has a medical "home"; a single, trusted doctor and care team, through which continuous, comprehensive and integrated care is provided.

The PCMH model includes a personal doctor and care team that will provide medical care.  When specialty care is needed, at the patient's request, the doctor and care team will personally manage, facilitate and coordinate the care with appropriate qualified professionals, such as hospitals, nursing homes, pharmacies and related community resources.

The PCMH model proposes to improve primary care by focusing on the patient-doctor relationship and to strengthen this dynamic through a more comprehensive approach to patient care and more active patient involvement.

How can the PCMH work for you? Click the link below to view an interactive demonstration on the PCMH, courtesy of Emmi Solutions:

The above video is owned and maintained by Emmi Solutions, LLC, whose ideas and opinions are expressed therein and do not necessarily represent those of the Blue Cross and Blue Shield Association or its member licensees.

What the Blues are Doing

Participating Blue Cross and Blue Shield companies are working with doctors, healthcare quality advocates, governmental entities, consumer advocate groups and employers to develop and test the PCMH model.

  • BCBS companies have PCMH initiatives in 39 states across the country that explore effective means of provider reimbursement and integrate quality improvement, care management and patient educational tools into primary care practices.  More than 4 million members are currently benefitting from care delivered through a BCBS PCMH initiative.
  • BCBSA works with outside quality and research organizations to ensure the effectiveness of PCMH pilots to enhance the primary care practice infrastructure and improve clinical quality, outcomes, affordability, and physician and patient satisfaction. Additionally, BCBSA serves as conduit for patient advocacy groups, employers, business coalitions, physician professional societies, government officials and other interested stakeholders wanting to partner with BCBS companies to further the PCMH model of care.

To learn more about PCMH activity in your area, contact your local Blue Cross Blue Shield company.

For more information regarding the PCMH and an interactive demonstration on what it means to patients, click here.

Patient satisfaction, delivered in accordance with an agreed care plan, is the hallmark of the PCMH.  Patients who receive care through the PCMH model will benefit from the following:

  • Access to doctors that utilize improved technologies to stay better connected with the medical community and manage care more efficiently.
  • Improved access to care through easier scheduling of appointments and extended office hours.
  • More focused, personal interaction with doctors and care teams that will help navigate through the complex healthcare system.
  • A more comprehensive delivery of primary care through the improved coordination of care, managed by the patient's personal doctor and their care team.