What is MiPCT?

The Michigan Primary Care Transformation (MiPCT) demonstration is a three-year project designed to improve the delivery of primary care and lower health care costs. The project will build on existing programs in the state to create patient-centered medical homes (PCMHs) for the delivery of primary care services and for chronic disease management in primary care settings.

How will the MiPCT project work?

All participating payers will offer financial incentives to providersto helptransform their practicesin the following areas:

  • Care management
  • Self-management support
  • Care coordination
  • Linkages to community services

Existing PCMH designation programs will be used.

Which providers are expected to participate?

Providers statewide will participate in MiPCT.[1] PCMH-designated practices already exist in more than 60 percent of Michigan’s counties, as designated through BCBSM’s Physician Group Incentive Program (PGIP). Under the MiPCT program, nearly 500 PCMH-designated provider practices statewide will be eligible for incentives.

Which payers will participate?

All major payers in Michigan will participate, including:

  • Private payers: Blue Care Network, Blue Cross Blue Shield of Michigan, Health Alliance Plan
  • Commercial plus Medicaid Managed Care plans: HealthPlus of Michigan, McLaren Health Plan, Physician’s Health Plan of Mid-Michigan, Priority Health
  • Medicaid Only plans: CareSourceMichigan, Great Lakes Health Plan, Health Plan of Michigan, Midwest Health Plan, Molina Healthcare of Michigan, Omnicare, Total Health Care, Upper Peninsula Health Plan
  • Other public payers: Medicare statewide and Fee-for-Service Medicaid statewide

How will incentives be determined?

Incentives will be shared with provider practices, based on performance, quality and use. A data repository will be in place for patient attribution and incentive payment determination.

How is the MiPCT project funded?

All participating payers will fund the MiPCT project, proportional to their membership.

CMS requires MiPCT to be budget neutral over the course of the three year project. This means that Medicare payments will be less than or equal to Medicare costs for similar populations outside the demonstration. To off-set the costs of provider incentives, MiPCT will create savings in the system by:

  • Decreasing emergency department use
  • Decreasing ambulatory care sensitive admissions and readmissions
  • Reducing the costs for treating chronic disease while improving overall population health

Who will administer MiPCT?

The Michigan Department of Community Health will oversee the project. In addition, the project will be guided by:

  • Asteering committee, to serve as the policymaking body for the project
  • An advisory committee, to provide information, resources and recommendations to the steering committee

Will patients know that their providers are focusing on a patient-centered approach to care?

Provider practices will be expected to give patients information about their efforts to employ PCMH principles.

For more information on MiPCT, contact:

  • Carol Callaghan, MPH, Director, Division of Chronic Disease and Injury Control, Michigan Department of Community Health, ; or
  • Jean Malouin, MD, MPH, Associate Chair for Clinical Programs, Family Medicine and Associate Medical Director, Ambulatory Care Services, University of Michigan,

[1]The University of Michigan Health System has a primary role in another related CMS demonstration, the Physician Group Demonstration Project (PGP v2), and therefore will not participate in MiPCT