The Introduction to Team-Based Care course helps the learner better understand how to work in a multidisciplinary care team and in collaboration with the patient. Open to all members of the practice to gain foundational knowledge in Team-Based Care. Introduction to Team-Based Care will include:

The goal of this course is for all Care Team Members to learn engagement tools/skills in order to have productive conversations with patients about their health including basic motivational interviewing skills.The Care Team Member will build upon this foundation in order to apply their skills in different situations, such as Medication Assisted Treatment, (MAT) and Palliative Care. The objectives of this course are:

Open to all members of the physician organization or practice staff interested in gaining additional knowledge of PDCM codes and foundational care management billing.

Open to all members of the practice to gain knowledge in medication reconciliation best practices.


This training gives participants the skills needed to support someone experiencing a crisis.


This training will create a foundation for introducing palliative care into the primary care setting earlier in the course of a serious illness.  Multiple training sessions have been created and are available to any physician or care team member who would like to attend. Additionally, several on-demand learning opportunities are available that can be viewed at any time.  


The Specialist Team-Based Care course is designed to provide care team members with an understanding of the Blue Cross Blue Shield of Michigan Specialist Team-Based Care Program and how teams work to support success in this program. Learn about processes and communication between Primary Care and Specialist offices to improve care coordination and patient outcomes.

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The predictive model initiative, offered through the PGIP program will focus on two key items, chronic kidney disease and serious illness. The use of the models increases the chances of early intervention, increased patient care and more informed decision making. This training will discuss how to identify and utilize the predictive indicators on the PDCM member eligible list.

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The goal for this education is to provide primary and specialist care teams a better understanding about the significant role of medications and diet in individuals with chronic kidney disease. Some medications may require dose adjustment or avoidance in the later stages of CKD due to nephrotoxic effects. Diet is also important throughout all stages of CKD and recommendations should be individualized to help improve patient understanding and compliance.

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