Columbia, S.C. - BlueCross BlueShield of South Carolina and Palmetto Primary Care Physicians this month are initiating a year-long patient-centered medical home pilot project that could become a model for South Carolina.
The patient-centered medical home, a concept backed by national medical societies and the Blue Cross and Blue Shield Association, is a first for BlueCross BlueShield of South Carolina, a first for Palmetto Primary Care Physicians and its patients, and a first in South Carolina involving an insurance company.
The pilot project will focus on diabetic patients who are members of BlueCross BlueShield of South Carolina, BlueChoice HealthPlan of South Carolina, and the State Health Plan.
Patient-centered medical homes integrate quality improvement, coordinated care management and patient educational tools into primary care practices. The concept places the primary care doctor in charge of a team that can include social workers, pharmacists, wellness coordinators, nurses, disease managers, clinical diabetic educators, all working together to proactively reach out and develop an individual treatment plan for patients.
Case managers, hired recently by Palmetto Primary Care Physicians, will help reduce gaps in care, such as missed appointments with specialists, lack of transportation, and medication non-compliance. They also will perform outreach, such as registering patients for wellness clinics, scheduling appointments with specialists and monitoring medical effects. The clinical quality goals will be monitored by measuring blood sugar levels and cholesterol levels.
Electronic medical records will be a key component for delivering comprehensive care. Palmetto Primary Care Physicians uses software, at the point of care, that integrates information received from the health plan, case manager and local emergency rooms. This is information that the primary care practice has never had before. The medical record then becomes more complete and readily available to the primary care physician. Palmetto Primary Care Physicians also has created a portal on its Web site where pilot participants can schedule an interactive e-visit with their physicians, create their own personal health records, upload and chart their own glucose results, and pay their bills.
There is no copayment or extra charge to the patients for participation in the pilot.
"BlueCross is excited about this innovative approach to care where physicians lead a team in this patient-centered medical home model," said Dr. Laura Long, BlueCross’ vice president of clinical quality and health management. "The goal is to reduce the disconnects in healthcare, improve quality of life for the patient, create tighter relationships and better communications, and add for the first time a focus on measurement of quality and continuous improvement of clinical outcomes."
If this pilot works well, it may be expanded to other chronic disease patients and to other primary care groups around the state. "We’re pleased to work with BlueCross and its diabetic members in this pilot and believe this could be a state model," said David L. Castellone, M.D, president of the Palmetto Primary Care Physicians board of directors.
Headquartered in North Charleston, S.C., Palmetto Primary Care Physicians has 48 providers and 350 employees in 18 clinics located in Charleston, Dorchester and Berkeley counties. Palmetto Primary Care Physicians has offices in: Summerville, North Charleston, Goose Creek, Daniel Island, Moncks Corner, Bonneau, Hanahan, and St. Stephen.
Headquartered in Columbia, S.C., BlueCross BlueShield of South Carolina (www.SouthCarolinaBlues.com) and BlueChoice HealthPlan of South Carolina (www.BlueChoiceSC.com) are independent licensees of the Blue Cross and Blue Shield Association. The only South Carolina-owned and operated health insurance carrier, BlueCross BlueShield of South Carolina and its family of companies include more than 20 subsidiaries involved in health insurance services, U.S. DoD health program and Medicare contracts, and other insurance and employee benefits services.