“We have seen definite improvements in the health of our patients enrolled in the program,” said Raana P. Naidu, MD, of Woodward Medical Clinic
Greenville, SC (PRWEB) December 20, 2012
Over 4,000 additional South Carolinians in Sumter, Orangeburg, Greenville and Pickens counties are eligible to participate in a new health care model designed to improve health outcomes, reduce cost and improve the patient’s experience.
The new model – patient-centered medical homes (PCMH) – was launched recently in physician practices in those counties with support from BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan of South Carolina.
In addition to their previously established patient-centered medical homes in Anderson and Greenville Counties, new Bon Secours Medical Group participants include the Center for Adult and Family Medicine, Covenant Internal Medicine, Doctors Family Medicine, Hillcrest Family Practice and Millennium Internal Medicine (all Greenville County); and Foothills Internal Medicine (Pickens County). Also hosting new patient-centered medical homes are Singleton Health Center and Medical Center of Santee in Orangeburg County; Colonial Family Practice in Sumter.
There are 4,090 newly eligible patients of these practices — patients who have diabetes, high blood pressure and/or heart failure and are members of BlueCross, BlueChoice® or the State Health Plan.
“This expansion will not only result in healthier residents, but will improve the quality of healthcare overall in our state,” said Tonya Edwards, MD, with Premier Family Practice in Greenville, S.C. Dr. Edwards is the first physician in the state—and Premier the first medical practice—to achieve Level III PCMH accreditation under the new 2011 standards. “Now, more providers in South Carolina have demonstrated their ability to meet the high standards required of a medical home to efficiently and effectively manage patient care.”
Patient-centered medical homes revamp how primary care is delivered and financed. These are not actual “homes,” but a new approach coordinated by a patient’s primary care physician. The physician systematically assesses the individual’s total health care needs, coordinates all of the care provided by a multidisciplinary team, assesses the results and adjusts the customized total care plan as needed.
In addition to paying the traditional claims, the insurance company provides a per–patient, per-month payment to the practice. This defrays the primary care doctor’s extra costs for providing case management, patient education materials, and other care coordination and quality improvement activities. Medical practices that document improved health outcomes receive an increased amount per member each month the next year.
“This is treating the whole patient, not just the illness. It’s proactive contact by their primary care provider for preventive care, coordination by that medical practice when the patient needs a specialist or has had emergency treatment or a hospitalization, and it can include assistance to overcome barriers such as finding community resources for someone who needs transportation,” said Dr. Laura Long, M.D., MPH, BlueCross’ vice president of clinical innovation and population health.
The new patient-centered medical homes join others started in recent years and supported by BlueCross and BlueChoice in Charleston, Lancaster, Columbia and Greenville. This brings the total number of South Carolinians eligible to participate to 23,000. The existing patient-centered medical homes already have shown results, such as fewer emergency room visits, fewer hospital admissions, fewer unnecessary tests and procedures, less illness and injury, and higher patient satisfaction. The goal is to achieve the “Triple Aim” of improved outcomes, reduced cost and enhanced patient experience.
“We have seen definite improvements in the health of our patients enrolled in the program,” said Raana P. Naidu, MD, a physician with Woodward Medical Clinic (a PCMH practice) and Medical Director/Quality Improvement & Physician Education for Bon Secours Medical Group. “They have taken ownership of their health by becoming more involved in their treatment.”
About Bon Secours St. Francis Health System
The Mission Statement of Bon Secours St. Francis Health System is to bring compassion to health care and to be Good Help to Those in Need®, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help bring people and communities to health and wholeness through the healing ministry of Jesus Christ and the Catholic Church.
With innovative technology, we heal the body. With faith, we mend the spirit. We draw from a past that's rich in the healing tradition, while strengthening the future through the guidance and support of the Ministry of Bon Secours and Bon Secours Health System, Inc.
About Bon Secours Medical Group
With more than 250 board-certified physicians in more than 50 Upstate locations, the ever-growing Bon Secours Medical Group brings together practitioners, physicians and surgeons to offer a wide range of specialties, from primary care to highly specialized surgery, to meet all the health care needs for Upstate families.
For more information, please visit http://www.stfrancishealth.org.
About BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina
Headquartered in Columbia, S.C., and operating in South Carolina for more than 65 years, BlueCross BlueShield of South Carolina (http://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 (http://www.BlueChoiceSC.com) of South Carolina also is an independent licensee of the Blue Cross and Blue Shield Association.