Specialist Value Based Reimbursement Results | Newsflash | May 2022

May 3, 2022

Specialist Value Based Reimbursement Results 

MPP is pleased to announce the results of the 2022 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.   Specialists are ranked into three tiers which earn 110%, 105% or 100% of the BCBSM Fee Schedule.  In 2022, 75% of the specialty practices in MPP received a payment uplift of at least 105%. All MPP PGIP specialty practices have been sent a 2022 Specialist VBR packet, including the practice’s individual dashboard of results. VBR achieved will remain in place until 2/28/2023. 2022 Specialist VBR is paid at a practice unit level for all specialists of the same specialty meeting the requirements. 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 2021, MPP physicians earned $7.2 million in VBR. This amount is up from $6.6M earned in 2020. 
If you have questions, please contact your Quality Team Member directly, or email us at MPPQuality@mclaren.org.