Changes to PGIP risk allocation

In the January 2019 issue of The Record, we announced the creation of the Physician Group Incentive Program Risk-Bearing Organized Systems of Care program. This directed 2% of the PGIP allocation to the risk allocation, funding the PGIP Risk-Bearing OSC program. The program focused on rewarding PGIP OSCs for managing the benefit cost trend of their attributed Blue Cross PPO patient population. 

The fund accumulation for the Risk-Bearing OSC program will end effective Dec 31, 2020 (with the rewards distributed to OSCs in 2021). Effective Jan. 1, 2021, the funds accumulated through the 2% risk allocation will be directed to the PGIP Reward Pool to fund physician organizations and OSC efforts to transform health care and improve the quality and efficiency of care.   

Providers contractually agree in their participation agreements to allocate a portion of their reimbursement to the PGIP fund. All funds allocated are distributed to physician organizations and OSCs that participate in PGIP to support physician practice and system transformation. No money is retained by Blue Cross Blue Shield of Michigan for administrative costs.