BCBSM of Michigan has released the results of the 2019 Specialist Value-Based Reimbursement (VBR) program. The VBR program is initiated through the Physician Group Incentive Program (PGIP) and your participation is administered by McLaren Physician Partners (MPP). We are pleased to share that 446 specialists were awarded VBR in 2019 through this program, an increase of over 10%, or 42 specialists from last year.
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, the middle tier receive 105% of fee schedule, and the bottom tier receive 100% of fee schedule. In addition to more specialists overall receiving VBR in 2019, we are also pleased to share that 99 physicians who were at 100% VBR two years ago are receiving 110% this year, showing greater improvement in managing cost, quality, and efficiency performance.
The Specialist VBR runs for a full year that began 3/1/2019 and runs through 2/29/2020. A Specialist VBR packet has been mailed to you regarding your specific results as well as tools and resources to earn and maintain your VBR.
Further guidance on interpreting your VBR dashboard as well as FAQs and educational webinar information can be found at www.MclarenPP.org under the Physician Education tab. Webinars have been scheduled to provide education on interpreting your report and materials, and are available on the following dates:
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Monday, April 1, 2019 at 12pm
- Wednesday, April 17, 2019 at 5pm
Further details regarding the webinars will be posted to the website.
f you have earned VBR in 2019, please ensure your charges are set higher than the fee schedule multiplied by the VBR amount in order 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 your Quality representative via email at mppquality@mclaren.org or call 248-484-4931 for more information on the Specialist VBR program.