Blue Cross and Blue Shield of Illinois Launches Patient-Centered Medical Home Pilot Programs in Chicago Area.

Pronger Smith Medical Care and Elmhurst Clinic Care participate, bring 20,000 patients into pilot

CHICAGO -- Blue Cross and Blue Shield of Illinois (BCBSIL) today announced that it has launched patient-centered medical home pilots with Pronger Smith Medical Care and Elmhurst Clinic, both of which serve patients in Chicago and its suburbs. The goal of patient-centered medical homes is to enhance quality and reduce growth in medical costs by improving the coordination of care.

In patient-centered medical homes, primary care physicians and their staffs monitor and coordinate most aspects of their patients' primary, specialty and other medical care. More than 20,000 BCBSIL members will be enrolled in the pilot programs, which are the first of their kind in Illinois involving multi-site medical practices and a single private payer. BCBSIL is providing data and clinical tools that will be used to coordinate care, track progress and analyze outcomes.

"If the pilots are successful in enhancing care and helping to control costs, they could serve as national models for health system improvement," said Scott Sarran, M.D., BCBSIL's chief medical officer. "We commend Pronger Smith and Elmhurst Clinic for their willingness to participate. These respected medical practices have indicated that they have the commitment and capabilities necessary to manage these pilots."

Pronger Smith launched its medical home program on August 1 with 18 primary care physicians working with 27 specialists.

"By collaborating with Blue Cross and Blue Shield of Illinois and piloting these new patient-centered concepts, we are arming physicians with better information to care for their patients, which can lead to healthier lives. We anticipate that centralizing communications with all providers of care, at all levels, with a primary care medical home will result in better outcomes for patients," said Dr. Yogesh Tejpal, M.D., managing partner, Pronger Smith. "We congratulate Blue and Cross Blue Shield of Illinois for taking a leadership role in this effort, and are happy to be part of the program."

Elmhurst Clinic consists of 35 primary care physicians working with about 65 specialists representing most medical fields.

"Doctors no longer have to do everything themselves. Medicine is too complex and there is too much information for one professional to manage. Elmhurst Clinic's culture stresses teamwork while maintaining the personal touch," said Donald R. Lurye, M.D., CEO of Elmhurst Clinic.

"Medical homes and related programs hold promise for improving the delivery of care if they effectively target patient populations most likely to gain from coordination, and are tied to specific steps to ensure greater physician and patient accountability for demonstrating better results," said Dr. Sarran.

BCBSIL, Pronger Smith and Elmhurst Clinic will continuously monitor the results of the pilot programs and after 12 months review the data to determine their impact on quality, costs and patient satisfaction.

Pronger Smith and Elmhurst Clinic are independently contracted medical groups that have contracted with BCBSIL to provide health care services to members enrolled in the health care benefit plans offered or administered by BCBSIL. Pronger Smith and Elmhurst Clinic, and their respective health care providers, are solely responsible for the health care rendered to patients.

With more than 7 million members, BCBSIL, a division of Health Care Service Corporation (HCSC), a Mutual Legal Reserve Company, is the largest health insurance company in Illinois. BCBSIL is an independent licensee of the Blue Cross and Blue Shield Association.