A More Connected, Personalized Care Experience: Patient‑Centered Medical Home Evolves to Advanced Primary Care
Debbie Reinheimer
| 4 min read
Key Takeaways
- Blue Cross’ primary care designation program reaches 2.9 million members through 1,579 PCMH practices and more than 6,800 providers statewide.
- Designated practices show 40% fewer adult inpatient stays, 29% fewer ER visits and 33.6% fewer hospital readmissions.
- Preventive care rates are substantially higher, including 173% higher childhood immunizations, 53% higher colorectal screenings and 68% better blood pressure control.
When your primary care team knows you, understands your health history, and designs your care plan around your personal needs, you stay healthier and spend less on healthcare.
That’s the idea behind Blue Cross Blue Shield of Michigan’s Patient Centered Medical Home (PCMH) program, a model of care that has been transforming how primary care is delivered across the state for nearly 20 years.
That transformation has been accelerating with the growth of Advanced Primary Care, a Blue Cross designation that recognizes a more comprehensive, proactive and personalized coordination of care approach that practice teams across Michigan are increasingly providing to their patients.
PCMH foundations
Blue Cross began its foundational PCMH designation program in 2009, working with physician organizations and primary care physicians.
A Patient‑Centered Medical Home is a care team led by a primary care provider that focuses on each patient’s health needs, and coordinates their health screenings, immunizations and preventive care. PCMH practices actively engage patients in their health care and help ensure these patients receive the right care, in the right setting, at the right time.
Over time, PCMH practice teams added support for patients’ behavioral health needs. Blue Cross created the Collaborative Care designation, for PCMH practices that integrate behavioral health directly into the primary care team. This helps patients quickly access treatment for anxiety, depression, or stress, and can reduce costs associated with untreated mental health conditions.
Moving forward: Advanced primary care
In recent years, Blue Cross has worked with physician organizations and primary care practices to expand the patient-centered care model to Advanced Primary Care (APC), the highest level of Blue Cross designation.
Practices earning APC designation have enhanced their care models by adding care management services in addition to their PCMH and Collaborative Care services. These practices have a strong focus on serving patients with multiple, chronic conditions, patients who are underserved, and patients who require ongoing coordination of services.
2026 designation program snapshot
Overall, the Blue Cross primary care designation program reaches members across Michigan:
- 1,579 PCMH‑designated practices across Michigan
- Over 6,800providers in those practices
- 398 PCMH practices have also earned Collaborative Care designation
- 300 PCMH practices have also earned Advanced Primary Care designation
- Designated practices deliver care to 2.9 million Blue Cross members
- Designated practices exist in 100% of Michigan counties that have a primary care practice
Personalized, proactive care for Blue Cross members
Across PCMH, Collaborative Care, and APC practices, care is designed around each member’s preferences, needs, and values.
Instead of waiting for health issues to become serious, care teams work with members to stay ahead of problems, connect them to the right care, and support them in managing their health on an ongoing and proactive basis.
In addition, designated practices emphasize prevention, early intervention, and personalized support. This can help catch issues early, improve long‑term health outcomes, and reduce the need for more expensive care later.
Designated practices consistently deliver higher‑quality preventive care than non‑designated practices.
2026 preventive care highlights
- 173% higher childhood immunization rates
- 59% higher pediatric weight assessment and counseling-BMI Total
- 53% higher colorectal cancer screening rates
- 33% higher breast cancer screening rates
- 68% higher rates of controlled blood pressure
Healthier members, lower costs
The 2026 results show that practices designated as PCMH, Collaborative Care and APC significantly outperform non‑designated primary care practices in key areas that affect both health outcomes and affordability:
- 40% lower adult ambulatory care‑sensitive inpatient stays*
- 29% lower adult primary care‑sensitive ER visits**
- 33.6% lower adult hospital readmissions
- 8.1% lower high‑tech radiology use
- 27.8% lower pediatric primary care‑sensitive ER visits
- 21% lower overall pediatric ER visits
These results demonstrate how coordinated, preventive, patient‑centered care keeps people healthier — and helps make health care more affordable for everyone.
In fact, the patient-centered model of care is estimated to have avoided $814 million in medical costs over 17 years, because doctors and their care teams have prevented disease, reduced hospitalizations and ER visits, and managed common and chronic medical conditions to keep members healthy.
To find a PCMH designated primary-care practice, go to BCBSM.com and select “Find Care.”
*Ambulatory care-sensitive conditions are those that shouldn’t require inpatient hospitalization if appropriately managed by a primary care provider.
**Primary care-sensitive conditions are those that should be managed by a primary care provider so that an emergency department visit isn’t necessary.
Photo credit: Getty Images
