BCBSF rolls out PCMH program statewide


Blue Cross and Blue Shield of Florida, Inc. (BCBSF) announced on Feb. 2 a statewide rollout of its Patient Centered Medical Home (PCMH) program. The aim is to provide comprehensive primary care that facilitates partnerships between individual patients, their personal doctors and, when appropriate, the patients' families “to allow better access to health care, increase satisfaction with care and improve overall health,” BCBSF said.

"Health care reform has helped renew the focus on the quality and affordability of care," said Dr. Jonathan Gavras, chief medical officer and senior vice president at BCBSF. "Our focus with the PCMH is to establish collaborative relationships with physicians to improve the delivery of quality care for members throughout the state."

BCBSF noted that primary care providers who give preventive health counseling, perform important screenings and immunizations, and assist with care coordination, are able to achieve lower rates of significant health issues for their patients.

Additionally, by establishing a stronger relationship between BCBSF, its network providers and its members, the program hopes to lower rates of hospitalization.

BCBSF's PCMH program initially will target chronic medical conditions that have major health implications for its members. Although available to all members, the PCMH program will focus on health maintenance, preventative care and overall management of members' progress with one or more of the following chronic diseases:

  • Diabetes
  • Chronic obstructive pulmonary disease
  • Coronary artery disease
  • Asthma
  • Congestive heart failure

To date, more than 1,500 primary care providers are enrolled in the PCMH program. Collectively, those doctors care for nearly 530,000 BCBSF members.

Enrolled providers will receive additional compensation from BCBSF based on adherence to program guidelines and overall patient results. PCMH doctors are encouraged to communicate directly with impacted members and their families about the program, and to jointly work together to reach their disease management goals.

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