S.C. Insurance Company, Hospital System Launch New Healthcare Model

A team-based healthcare delivery system focused on integration of patient services is now being offered by BlueCross BlueShield of South Carolina and Bon Secours Medical Group.

Patient-centered medical home, or PCMH, is a new model that essentially streamlines and integrates all facets of a patient's healthcare together, putting the primary physician in charge of coordination of all services, such as checkups, tests, support, referrals to other providers and follow-up for urgent care, emergency services and hospitalizations to ensure that all of the patient's problems are addressed.

The new model will initially focus on Bon Secour patients sufering from diabetetes, congestive heart failure and hypertension who are BlueCross members or members of BlueChoice Healthplan of South Carolina or the State Health Plan.

"This is a great opportunity to help patients with chronic conditions improve their health," said Raana P. Naidu, MD, with Woodward Medical Clinic and BSMG Medical Director/Quality Improvement & Physician Education. "The PCMH is a perfect fit with our belief in patient-centered care—treating the whole patient, not just the illness."

The first group of BSMG practices implementing the PCMH includes Cornerstone Family Medicine, Milestone Family Medicine, Piedmont Family Medicine, Poinsett Family Practice, Premier Family Medicine, Simpsonville Family Medicine and Woodward Medical Center.

Combined, these practices have 2,900 eligible patients who are being contacted to let them know they are automatically enrolled free in the program and how it works. The new model affects both the way primary care is administered, as well as how it is paid for.  In addition to paying the traditional fee-for-service claims, BlueCross and BlueChoice provide financial rewards to the medical practice. Practices are given a per-patient, per-month payment from BlueCross and BlueChoice to defray costs for providing case management, patient education materials and other care coordination and quality improvement resources and activities.