MPP Specialist Value Based Reimbursement Results | May 2023 | News Flash

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May 10, 2023

MPP Specialist Value Based Reimbursement Results

MPP is pleased to announce the results of the 2023 BCBSM Specialist Value Based Reimbursement (VBR) program. This program was developed to reward specialists for performance in population healthcare delivery by promoting responsibility for the cost and quality of care of a shared population of patients. It rewards Specialists to engage in the Patient‐Centered Medial Home Neighborhood and their collaboration with Primary Care Physicians.

 

VBR is administered through the Physician Group Incentive Program (PGIP) and your nomination came from McLaren Physician Partners.  

  • 84% of the specialty practices in MPP received a payment uplift compared to 75% in 2022.
  • Specialists are ranked into three tiers which earn 110%, 105% or 100% of the BCBSM Fee Schedule.
  • Core Metrics: Cost of Care PMPM, Cost PMPM Difference (change over last year), Global Quality Index
  • All MPP PGIP specialty practices have been sent a 2023 Specialist VBR packet, including the practice’s individual dashboard of results.
  • VBR achieved will remain in effect from 3/1/2023 - 2/29/2024.  It is important to make sure your charges are set higher than 110% of the BCBSM fee schedule, as BCBM will apply a lesser of charges rule to all claims.

 

Our primary and specialty practices earning VBR continues to increase year over year. In 2022, MPP physicians earned $7.3 million in VBR.

 

If you have questions, please contact your Quality Team Member directly, or email us at

[email protected].