BCBS South Carolina Patient-Centered Medical Home Program

Program Location: 
Charleston, SC
Payer Type: 
Blue Cross Blue Shield South Carolina

Reported Outcomes


BlueCross BlueShield South Carolina is connecting physicians, nutritionists, care coordinators and even pharmacists ensuring that patients are provided with comprehensive care and a full understanding of their medications.  BlueCross BlueShield of South Carolina has several Patient-Centered Medical Home (PCMH) practices in their network across the state. 

Payment Model: 

The patient-centered medical home compensation model is a blended payment methodology that recognizes infrastructure changes and enhanced patient services: Fee-for-service payment, including payments for some non-traditional services (e.g., electronic visits, pharmacist consultations). Per-member, per-month care coordination fee. Bonus adjustments to care coordination fee for quality outcomes.

Fewer ED / Hospital Visits: 
  • 36% fewer hospital days
  • 12.4% fewer emergency department visits
  • Hospital admission rates were 10 percent lower per 1,000 patients
Cost Savings: 
  • 6.5% reduction in total medical and pharmacy costs compared with controls
Last updated March 2019
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