Value Partnerships Update Banner with 5 physicians face outward with the Blue Cross Blue Shield Card slightly over the image Value Partnerships Update Banner with 5 physicians face outward with the Blue Cross Blue Shield Card slightly over the image
April 2019

Blue Cross Blue Shield of Michigan

 

PGIP and risk allocations apply to most procedure codes, effective April 1

The Physician Group Incentive Program and risk allocations apply to most professional procedure codes regardless of the billed provider charge. We previously told you this change would be effective Jan. 1, 2019, it did not occur until March 22, 2019.

Also, as of April 1, providers see a voucher message that represents each of the two allocations described below. There is no change in the overall percentage.

Voucher graphic

As previously communicated, the 7 percent PGIP allocation is directed as follows:

  • Blue Cross directs 2 percent to fund the 2019 PGIP risk-bearing OSC program. This program rewards OSCs for managing the benefit cost trend of their attributed Blue Cross PPO patient population and is the first step in our risk strategy.
  • The remaining 5 percent rewards eligible physician organizations and OSCs for improving the quality of patient care, system and practice transformation, and reducing costs.

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