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Specialist Value-Based Reimbursement (VBR) 2018

Published on Thursday, April 26, 2018

The Blues of Michigan have released the results of the Specialist VBR program.  This program comes through the Physician Group Incentive Program (PGIP), administered by McLaren Physician Partners.  We are pleased to share that 404 specialists were awarded the VBR in 2018 through this program, an increase of 113 specialists from last year!  Physicians participating in PGIP through MPP earned $5 million in VBR revenue in calendar year 2016. 

The PGIP ranks participating specialists into 3 tiers based on cost, quality, and efficiency scores within peer groups.  The top third receive 110% of fee schedule, middle tier receive 105% of fee schedule, and bottom tier receive 100% of fee schedule.  In addition to more specialists receiving the VBR in 2018 we are also pleased to share that 99 physicians moved from 100% or 105% last year to receiving 110% VBR this year, showing greater improvement in managing cost, quality and efficiency performance

The VBR runs for a full year that began 3/1/2018 and runs through 2/28/2019.  A Specialist VBR program summary has been mailed out and will soon be found now on our CareSpective physician portal, indicating your results and earned VBR.  If you are unsure of how to access the portal, you can contact your local Quality Performance Specialist to you help you obtain access, or contact Scott below.  Both CareSpective and a grid of local MPP staff who are able to assist you can be found at McLarenPP.org. 

If you have earned VBR in 2018, please ensure your charges are adequately set to maximize your earned VBR.  A lesser of charges rule applies to your billings, meaning the VBR cannot be added to billings and you forfeit the additional amount for which you are eligible. 

If you have questions, please contact Scott Johnson at (248) 484-4924 or Scott.Johnson@mclaren.org