Bluestone Physician Services
Bluestone Primary Care
Delivering great outcomes to patients living with chronic conditions
Our unique, robust model of care is tailored to patients living with multiple complex, chronic conditions and disabilities, and is delivered in their comfortable, familiar surroundings at living communities throughout Minnesota, Wisconsin and Florida.
Bluestone Primary Care Providers — Physician Assistants or Nurse Practitioners who partner with a collaborating Physician — lead an integrated team of nurses, social workers, complex and behavioral health care managers, and collaborate with living community staff, other providers and families, to help patients manage their health and achieve quality of life goals.
With Bluestone Primary Care, patients receive:
- Routinely scheduled on-site, in-home visits to adequately manage complex and chronic medical conditions.
- Urgent care and same day visits to address acute concerns — in person and via telehealth.
- Regular assessment of falls, cognitive status, depression and frailty.
- Comprehensive care plan development to ensure alignment of treatment plan and resources with patient-centered goals of care.
- Referrals to specialists as appropriate.
- Access to the Bluestone care team 24/7 via:
- Phone including after hours on-call provider
- The Bluestone Bridge: simple, effective communication platform that connects patients, their care teams, community staff and family 24/7.
Bluestone is contracted with most major Medicare and Medicaid plans and bills your insurance — just like a primary care clinic.
Supporting Care Programs
Support with Managing Chronic Conditions
Available to those living with one or more chronic conditions, Advanced Primary Care Management (APCM) services help us manage patients’ health between visits. APCM includes communication with community staff and family; coordination for specialists, physical therapists, home health, and more; and support in case of an ER, hospital, or skilled nursing transition.
Behavioral Health Services
Bluestone Providers, Behavioral Health Care Managers, and Psychiatric Consultants collaborate to support patients’ mental and behavioral health, which includes medication management and non-pharmacological strategies to address behavioral concerns and monitor progress. They also educate and support community staff and family members. Talk with your provider to get started.
Dementia Care Navigation
Guiding an Improved Dementia Experience (GUIDE) is a program for people with Traditional Medicare and their caregivers. Bluestone Care Navigators facilitate access to services, educate caregivers about the diagnosis and best practices, and provide ongoing support to improve patients’ and caregivers’ quality of life.
Bluestone Accountable Care Organization
Patients with Traditional Medicare can join the Bluestone ACO and receive extra benefits to coordinate care and avoid unnecessary hospital stays. ACOs are a Medicare program to improve quality of care, health outcomes and reduce costs. Bluestone ACO led the U.S. in 2022 and 2023 — learn more here.
Bluestone Care Coordination
Available to members enrolled in Minnesota SNBC & MSHO health plans, Bluestone Care Coordinators (RN or LSW) assess a person’s physical, mental and social determinants of health, and facilitate services and communication across the care team to ensure all needs are met.
Our Partners in Care
Assisted Living and Memory Care Communities
We partner with more than 575 Assisted Living and Memory Care communities across Minnesota, Wisconsin and Florida — see all of our locations here. Interested in bringing Bluestone to your community? Let us know here.
Group Homes, Supportive Housing, and Adult Foster Care in Minnesota
We partner with more than 500 Group Homes, Supportive Housing, and Adult Foster Care communities in Minnesota to address common barriers that people living with disabilities and mental health needs face when navigating the health system through our ADAPT Program: Accountable Care | Disability Competent | Accessible | Patient-Centered | Team-Based.
ADAPT Physicians, Physician Assistants, Nurse Practitioners specialize in the unique needs of patients who live with a developmental, intellectual, and physical disability, including cerebral palsy, quadriplegia, traumatic brain injuries, epilepsy, as well as mental health conditions, including schizophrenia, depression and anxiety.
Interested in bringing Bluestone ADAPT to your community? Contact Bluestone ADAPT Senior Program Manager Carolyn Forster at Carolyn.Forster@bluestonemd.com.
Seamless Collaboration with Home Care and Hospice Agencies
Home care and hospice agencies play a critical role in quality patient care. We foster strong partnerships with any agency providing care to our shared patients. To ensure continuity and collaborative care, we provide our home care and hospice partners with direct access to The Bridge, our secure communication platform, which allows for real-time information exchange, coordinated care planning, and a unified approach to patient support … all leading to better outcomes and patient experience.
Phone: 877-599-1039
Fax: 651-342-1428
Bridge & Portal Help Desk
855-794-9476