BCBSAZ

Population Health | PCMH

PCMH: Patient-Centered Medical Home

PCMH—What is it?

The Patient-Centered Medical Home (PCMH) is a care delivery model defined as "a healthcare setting that facilitates partnerships between individual patients and their personal providers, and when appropriate, the patient's family." *

Blue Cross Blue Shield of Arizona (BCBSAZ) began the PCMH program in mid-2011 to promote better communication and closer contact between patients and their primary care physicians. The goal of the PCMH program is to improve patient care outcomes by encouraging Primary Care Physicians (PCPs) to practice high quality evidence-based medicine.

* American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, and American Osteopathic Association. (2007 Mar). "Joint principles of the patient-centered medical home"

The Patient-Centered Medical Home encompasses the following functions and attributes:

Accessible Services Evidence-Based Care
  • Shorter Waiting Times
  • Enhanced In-Person Hours
  • Around-the-clock Access
  • Alternative Methods of Communication
  • Improved Chronic Condition Management
  • Compliance with Preventive Care Guidelines
Coordinated Care Patient-Centered
  • Specialty Care
  • Hospitals
  • Home Health Care
  • Community Services
  • Relationship-Based
  • Partnering with Patients and Family
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PCMH program brochure

View Brochure

The PCMH Program offers financial incentives in connection with evidence-based care guidelines developed to help you manage patients with chronic diseases.

The program promotes:

  • Better communication with patients
  • Improved patient care outcomes
  • Evidence-based guidelines




In addition, PCPs will be expected to guide the total care of their chronic disease patients who are part of the PCMH program through the medical system. This includes adopting practices such as:

  • Managing chronic disease patients to ensure compliance with care guidelines. The PCMH program currently includes six chronic disease conditions:
    • Asthma
    • Congestive Heart Failure (CHF)
    • Congestive Obstructive Pulmonary Disease (COPD)
    • Diabetes
    • Hypertension
    • Coronary Artery Disease (CAD)
  • Using high quality cost-effective consultants, when medically necessary
  • Directing the patients to high quality cost-effective facilities, when medically necessary
  • Using generic drugs whenever possible
  • Avoiding poly-pharmacy
  • Encouraging appropriate members to participate in wellness and disease management programs

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Interest Form

View Interest Form Are you interested in participating in our PCMH program? View or download the
The participation criteria for providers include, but are not limited to, the following:
  • The providers must be, and remain, contracted with BCBSAZ throughout their involvement with the PCMH program.
  • The physician's current practicing specialty must be Internal Medicine, Family Practice, General Practice or Pediatrics.
  • The physician must be seeing patients in an office setting.

What we need from you:

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Resources for PCMH Information

Discover more resources for PCMH at the National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC).

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