S.C. BlueCross and Palmetto Primary Care Physicians' Collaboration Improves Health of Diabetes Patients
December 1, 2011
COLUMBIA, SC – December 1, 2011 – More than 800diabetes patients are enjoying better health thanks to a coordinated approach tocare sponsored by BlueCross BlueShield of South Carolina, BlueChoice® HealthPlan and Palmetto Primary Care Physicians.
That’s the outcome of atwo-year study examining a centralized program called a patient-centered medicalhome. The approach focuses on primary care. It centralizes delivery of healthservices and links provider reimbursements with patient health outcomes.
The diabetes patients weremembers of BlueCross and of BlueChoice HealthPlan of South Carolina. Theirhealth improved in the first year of the study and even more during the secondyear, which ended recently. They had 14.7 percent fewer inpatient hospital daysand 25.9 percent fewer emergency room visits. They had better control of theirblood pressure, cholesterol and glucose levels. They also had healthier bodymass index (BMI) rates, and more of them received eyeexams.
In a patient-centered medicalhome, patients are cared for by a primary care physician who leads a fullmedical team. The team coordinates all aspects of patient care, from preventiveand acute care to managing chronic health needs. BlueCross and BlueChoiceHealthPlan changed their pay models to include a per member, per month fee and abonus for improved health results, in addition to the typical fee-for-serviceclaims. Palmetto Primary Care Physicians hired care coordinators specificallyfor this group of patients. The care coordinators contacted patients regularlyand helped them through the complexities of the health caresystem.
We changed our pay model andPalmetto Primary Care Physicians changed their delivery model. Under thisarrangement, our members made even greater strides in managing their conditionsin the second year, thanks to the addition of care managers and a team effortcentered on the patient, said Dr. Laura Long, BlueCross’ vice president ofclinical quality and health management. This reinforces our belief thatpatient-centered medical homes are the front line to better outcomes, betterhealth and lower costs for our members.
This patient-centered medicalhome was BlueCross’ first in the state. BlueCross has since establishedpatient-centered medical homes for heart failure patients with primary carepractices at the University ofSouth Carolina Family Medicine practicein Columbia and Mackey Family Practice inLancaster.BlueCross is expanding the model to other locations in South Carolina. Inaddition to diabetes, some programs will focuse on hypertension, or high bloodpressure.
Charleston-based PalmettoPrimary Care Physicians has 26 sites in Charleston, Berkeley and Dorchester counties.
About BlueCross BlueShieldof South Carolina
Headquartered in Columbia,S.C., and operating in South Carolina for nearly 65 years, BlueCross BlueShieldof South Carolina (www.SouthCarolinaBlues.com) and BlueChoiceHealthPlan of South Carolina (www.BlueChoiceSC.com)are independent licensees of the Blue Cross and Blue Shield Association. Theonly South Carolina-owned and operated health insurance carrier, BlueCrossBlueShield of South Carolina comprises more than 45 companies involved in healthinsurance services, U.S. DoD health program and Medicare contracts, otherinsurance and employee benefits services, and a philanthropic foundation thatfunds programs to improve health care and access to health care for SouthCarolinians.
