The Michigan Primary Care Transformation Project (MiPCT) - Michigan

Program Location: 
Ann Arbor, MI
Number of Practices: 
346
Payer Type: 
Multi-Payer
Payers: 
Blue Care Network
Blue Cross Blue Shield of Michigan
Priority Health
Centers for Medicare and Medicaid
Michigan Medicaid
Medicare

Reported Outcomes

Description: 

The Michigan Primary Care Transformation Project (MiPCT) is a three-year multi-payer project aimed at improving health in the state, making care more affordable, and strengthening the patient-care team relationship. The MiPCT is state-wide in scope and is the largest Patient-Centered Medical Home (Patient-Centered Medical Home) project in the nation. Five hundred primary care practices and 1800 primary care physicians that are affiliated with one of 41 physician/physician hospital organizations (POs/PHOs) are eligible to receive payments.

According to Kaiser Family Foundation, enrollees through Blue Cross Blue Shield of Michigan, the Blue Cross HMO (Blue Care Network), west-Michigan based HMO Priority Health, Medicare and Medicaid are included in the demonstration. MiPCT requires participating primary care practices to achieve designation as a PCMH, either through BCBSM or the National Committee for Quality Assurance (NCQA). The program also incorporates a statewide patient advisory council. 

Key MiPCT Interventions:

  • Clinical
    • care managers embedded in primary care offices
    • population management support
  • Financial
    • additional payment for care management and population management
  • Data and information
    • multipayer database, member lists, dashboards that provide feedback on performance
Payment Model: 

All participating payers will provide funding to PO/PHO/primary care practices and providers to build and strengthen advanced primary care practice capability to deliver patient-centered care. Practices or providers participating in the demonstration will receive three payment components as follows, beginning January 2012: Care coordination payment – $3.00 per member per month ($4.50 for Medicare) Practice transformation payment – $1.50 per member per month ($2.00 for Medicare) Performance incentives – $3.00 per member per month Payers will also contribute $.26 PMPM to MiPCT for administrative costs. support physicians and practice transformation by providing educational opportunities, a Care Management Resource Center, and the Michigan Data Collaborative. The focus of support is on care management, self-management, care coordination and linking to community services. Educational opportunities include learning collaboratives, lean workshops, practice-based coaching, webinars, and seminars. The Michigan Data Collaborative will create a multi-payer claims database and generate metric feedback reports.

Cost Savings: 

RTI International (January 2015)

  • Michigan is one of 2 states that reduced rate of growth in Medicare FFS expenditures in the first year of implementation
  • estimated reductions of about $148 per full-year eligible medicare benificiary
Last updated Luglio 2015
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