PGIP Information

2016/2017 Specialist Value Based Reimbursement (formerly specialist fee uplift)

MPP has participated in the BCBSM PGIP Specialist Uplift Initiative (Now referenced Value Based Reimbursement, VBR) since 2012.  For 2016 all specialists are eligible for the VBR for BCBSM Commercial members Uplift applies to RVU codes and Anesthesia time codes.  The nominations were completed in September, 2015, and uplift began March 1, 2016 through February 28, 2017.

Nominations for the 2017 VBR begins in the Fall of 2016.

For each nominated practice unit, the PO must attest to the presence of a signed PCP-Specialist agreement based on PCMH-Neighbor principles.  MPP will be distributing these agreements in July-September, 2016.

3 keys to success in BCBSM Value Based Reimbursement

    1. Take responsibility for cost of care
    2. Identify opportunities to reduce cost and improve quality
    3. Embrace Patient Centered Medical Home-Neighbor and medical neighborhood