Detroit Regional Chamber > Member News > MedNetOne Health Solutions participating in new High Intensity Care Management program with Blue Cross Blue Shield of Michigan

MedNetOne Health Solutions participating in new High Intensity Care Management program with Blue Cross Blue Shield of Michigan

November 4, 2014
Rochester, Mich. –Nov. 4, 2014 – MedNetOne Health Solutions (MNOHS), a Michigan-based healthcare management organization serving the infrastructure and clinical support needs of private practice physicians and behavioral health specialists, announces it is participating in the new High Intensity Care Management model (HCIM) launched Oct. 1 by Blue Cross Blue Shield of Michigan (BCBSM). Started at the national level by the Centers for Medicare & Medicaid Services, HICM refers to a suite of services offered to the Medicare Advantage population and supported in Michigan by BCBSM and Blue Care Network. Greater Macomb Physician Hospital Organization is working in partnership with MNOHS on the HICM model.

Previously the domain of national disease management organizations, the new HICM model is designed to offer team based health care, with a primary care physician in the lead, to select Medicare Advantage patients in southeast Michigan who have at least six of 14 chronic condition diagnoses (co-morbidities). HICM identifies and serves patients through three levels of care:

1. Tier One: for patients who are stable and require a maximum of one primary care visit and/or one phone call per month
2. Tier Two: for patients who are moderately ill and require more regular follow-up and touch points with their primary care physician/team
3. Tier Three: for patients who are seriously ill and require weekly or daily contact with a primary care team member and/or a member of the extended team, such as an Advance Practice Nurse (AP-N), R.N., MSW, pharmacist or home care agency.

MNOHS CEO, Ewa Matuszewski, acknowledged the challenging scope of the HICM initiative.

“The High Intensity Care Management model is definitely ambitious, but is a logical step in the patient-centered, population-based care movement,” said Matuszewski. “The Medicare Advantage patients involved in the program have multiple physical and psycho/social health needs and will greatly benefit by a local, broad-based care team that can serve them on the health care continuum.”

Prior to the October 1 rollout, a select number of MNOHS physician group membersparticipated in a month-long preparatory phase of HICM. These practices worked with approximately 70 Medicare Advantage patients to determine how the initial HICM process outline would achieve the desired outcomes.

“The preparatory phase offered important insights on the adequacy of efforts to identify and capture all of the diagnoses for the Medicare Advantage patients assigned to the practice, to test run whether the communication strategy among the health care team can help achieve patient care goals, and how best to handle the transfer of patients into the HICM program,” said Matuszewski. “Since that time, the MNOHS team has seen nearly 900 patients through HICM, given the demand for comprehensive health care services for this population.”

About MedNetOne Health Solutions:
MedNetOne Health Solutions (MNOHS), a leader in advancing the development and implementation of the Patient-Centered Medial Home (PCMH), is a health care management organization for primary and specialty care physicians and behavioral health specialists that provides administrative infrastructure and clinical support and programming to develop and sustain high performing, patient-centric practices while meeting government healthcare reform mandates. Learn more at