By EWA MATUSZEWSKI
A giant in Michigan’s healthcare community, an advocate for primary care physicians and physician organizations, and someone who has come to be a dear friend and mentor, is retiring—and I cannot let this milestone pass without lavishing praise. Dr. Tom Simmer, until Dec. 31, the Chief Medical Officer of Blue Cross Blue Shield of Michigan, will not like this attention—but he certainly deserves it.
Tom advanced the goals and efforts of primary care in a brilliantly simple way: understand the role that physician organizations play in optimizing patient outcomes in primary care, then tap into their reach for population health for a greater patient impact. As population health became the mantra for identifying and advancing primary care initiatives that could tackle tough to manage chronic conditions such as asthma, depression, hypertension, heart disease, and diabetes – and the co-morbidities they frequently spawn – Tom knew that a targeted approach was the best option for incorporating population health into the primary care vernacular. He also knew that reaching primary care physicians (he started his career as an internist) was best accomplished by accessing their physician organizations.
Until his tenure as Chief Medical Officer, BCBSM had never partnered with PO’s, preferring to work directly with physicians – as challenging as that was proving to be amid increased demands for billing codes, reimbursement and a myriad of new quality metrics that were confounding primary care physicians, especially those in solo or smaller practice.
His strategic decision-making in recognizing the value of POs in primary care led to the establishment in 2004 of BCBSM’s Physician Group Incentive Program (PGIP), which brought the previously disjointed Michigan physician community together through financial incentives around population health programs so vital to comprehensive primary care. Now linked to Value Partnerships, the PGIP efforts have been profoundly successful and continue to evolve.
Among its greatest achievements under Tom’s direction was the establishment in 2009 of the patient centered medical home ‘demonstration project’, which rallied approximately 1,800 primary care physicians from 500 practices into a new era of foundational primary care. Tom saw the PCMH tenets already being practiced in primary care practices, but he knew the concept could be formalized and replicated only through the financial support of payers like BCBSM.
In championing the PCMH model, which remains at the heart of high-performing primary care practices in Michigan today, Tom made it easier for POs to work with their member practices to reinforce the merits of the PCMH model and also introduce a more formal means to track and measure quality scores based on patient outcomes, further incentivizing physicians and their practice teams to understand how to best serve their patient population. This new way of thinking led to other innovative programs introduced by POs. For example, our own community care travel team, partially funded by PGIP dollars, allows us to bring a multi-disciplinary team of clinical professionals such as behavioral health specialists, dietitians, pharmacists, nurses and diabetes educators directly into primary care physician practices to treat patients with at-risk conditions while keeping the PCP at the center of the clinical team.
Tom Simmer is a legendary physician and servant leader whose initiatives set a blueprint for quality. His approach is always collaborative, collegial, and patient-centered. As he heads into a well-deserved retirement, Tom leaves a strong foundation of primary care and primary care advocacy in Michigan. I’m sure I speak on behalf of the Michigan physician organization community when I say that his guidance and wisdom have left a bookmark in our state’s primary care history and will allow us to boldly move forward following his example.
To that end, I am pleased to announce a donation from MedNetOne toward the formation of the Thomas L. Simmer, M.D. visiting professorship at Oakland University, which will fittingly focus on interprofessional collaboration. The endowment establishes interdisciplinary campus partnerships between the School of Health Sciences, The Schools of Medicine and Nursing, and the College of Arts and Sciences relating to mental health and wellness. Readers, your support is welcome to help grow the endowment and pass the baton onto the next generation of healthcare leaders – so ably modeled by Tom Simmer. Thank you, Tom.