Memorial Healthcare

The BHN program produced a system-wide “ripple effect” that energized departments across the organization including family medicine, neurology, billing, marketing, and IT around Alzheimer’s disease care, with each department gaining a clearer understanding of the changing AD landscape and the role of the BHN. A time-based PIN billing model was established that aligns with existing BHN responsibilities without adding new documentation burden, allowing 60-minute increments with an additional 30-minute add-on when needed. Active expansion of the BHN role to outlying primary care practices in surrounding communities is underway, using a traveling-BHN model that brings the navigator to patients rather than requiring patients to travel to the main hospital.

Successes included alignment of the new PIN billing strategy with existing BHN workflow (no added documentation, no new staff workflows, broad flexibility in consent capture), strong multi-departmental buy-in across family medicine, neurology, billing, IT, marketing, and the executive team, and positioning of the program as a system-wide initiative rather than a single-department project. Although initially the BHN program was driven by the neurology department, primary care physicians are now the daily champions and key drivers of program success. Working with the billing and IT departments to operationalize PIN code billing, documentation, and EMR support required iterative effort. The geographic spread of primary care clinics across Shiawassee County also required developing a traveling-BHN model, with the navigator going to outlying clinics rather than concentrating evaluations at the main hospital campus.

The program is continuing with executive team approval and is actively expanding from the King Street pilot site to family medicine clinics in Durand and Corunna, MI. The time-based PIN billing model has established a sustainable financial pathway aligned with the actual care-coordination work performed, with the overseeing provider eligible to receive RVU credit for BHN-supported care. Memorial Healthcare’s confidence in the model is grounded in having overcome the early billing challenges, and the team expects continued growth to enable a greater number of patients to be screened, evaluated, diagnosed, and treated appropriately.