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About e Physician Group Incentive Program. e Physicians Group Incentive Program began in 2005. e program consists of more an 20,000 pri y care and specialist physicians in Michigan involved in quality improvement efforts. BCBSM – PGIP Quarterly Meeting Lansing Community College – West Campus 5708 Cornerstone Drive, Lansing, MI 48917 27, – 8:00.m.-3:30 p.m. Attire Business Casual LCC WIFI INSTRUCTIONS ARE ON E TABLE. PGIP Quarterly Meeting ch 12, 20. 2-1-1 Mission: Michigan 2-1-1 connects people wi information and resources to build heal y, safe communities. Our Mission for today is: Explore how 2-1-1 serves as your community resource program to support heal and human services needs. At e quarterly Blue Cross Blue Shield of Michigan (BCBSM) Physician Group Incentive Program (PGIP) meeting, PatientPing spoke on a panel about statewide notifications to over 0 physician organization representatives, including many of PatientPing’s current customers. As a Qualified Organization of MiHIN, e Michigan heal information. Physician Group Incentive Program Program Updates 14, Tom Leyden, MBA Director, Value Partnerships. PGIP Program Grow BCBSM PGIP Quarterly Meeting: 14, . PGIP) practices. Participating groups provide periodic reports to BCBSM on eir progress on pre-determined measures. Each physician group's share of e incentive payments is based on performance in achieving program goals. BCBSM facilitates several meetings each year (usually quarterly) wi e engaged physician group leadership to discuss plans for. Physician Group Incentive Program Improving patient care, reducing heal care physicians have joined wi BCBSM to help improve e quality, value and efficiency of heal care in e state. ey’re not only having an impact on 1.7 million BCBSM members, but receiving ads attend quarterly meetings, participate in interest groups. 26,  · e COVID-19 pandemic is challenging e speed and resiliency of many heal organizations as situations and protocols rapidly change. Because of e statewide collaborations already in place rough Blue Cross Blue Shield of Michigan’s Value Partnerships platform, physician organizations and practices roughout e state have been able to connect and share vital . Value Partnerships Overview Hospital Pay for Performance Physician Group Incentive Program Value-Based Reimbursement. Our Provider Newsletters. Help. Value Partnerships Overview. Value Partnerships is a collection of programs from Blue Cross Blue Shield of Michigan, physicians and hospitals across Michigan at make heal care work better for. Have Questions? Call 877-258-3932. Privacy Policy 1996-Blue Cross Blue Shield of Michigan and Blue Care Network Nonprofit corporations and independent licensees. Physician Group Incentive Program: Physician Organization Role • Collaborate on crafting future vision • Collaborate on implementation –PGIP quarterly meetings –Common interest groups –Initiative leadership teams –Regional learning collaboratives • Animate physician members • Develop and deploy new systems of care. BCBSM PGIP Quarterly Meeting ch 13, 2009 Lansing Community College. PCMH Designation Program Update. All information is preliminary - based on 11-08 PCMH self-reported info & 2007 claims data. results & me odology subject to change. 2. Agenda.. Review of Previously Communicated Quality and Use Criteria for PCMH Designation. Physician Group. Incentive Program. PGIP quarterly meetings In 2008 and 2009, BCBSM developed 12 PGIP initiatives designed to help Michigan PCP and specialty practices develop e capabilities associated wi e Joint Principles. BCBSM’s PGIP PCMH Initiatives. Convene Quarterly Meetings PGIP Total 1,240,468 12,086,869 36,730 28,656 78.0 36,730 27,178 74.0 36,730 29,363 79.9 27,013 19,203 71.1 BCBSM Incremental Approach to PCMH Developed in Collaboration wi PGIP Providers PGIP PCMH Initiatives. Physician Group Incentive Program. Partially Embedded Practice Model. Objective: is document outlines standards to facilitate strong team-based care and forge an effective relationship between e care team member and e physician, for practices at utilize a care manager who is not physically present at e practice to deliver patient care. (BCBSM and Priority Heal) BCBSM supports multipayer care management PGIP PCMH practices for eligible commercial BCBSM patients wi a PDCM benefit. Billing can be submitted for eligible commercial BCBSM patients wi a PDCM benefit in PGIP PCMH practices. For fur er details, practices should contact eir PO representative. e DMC PHO has selected e following ten BCBSM Physician Group Incentive Program (PGIP) initiatives for participation: Increasing e Use of Generic Drugs (GUR) Radiology Management. BCBSM’s facilitation of quarterly meetings wi all PO leaders (approximately 350) has led to cross-collaboration and synergistic partnerships among providers across e state, as well as e formation of a Pri y Care Leadership Committee at provides review and guidance on PGIP policies and programs. BCBSM/BCN incentive program’s quality measures are similar to ose of e Patient-Centered Medical Home program, for which Beaumont ACO provides quarterly scorecards for practices to monitor eir progress. Beaumont ACO program coordinators will be meeting wi practices in e first quarter of. e BCBSM incentive program also requires at participating oncologists attend quarterly PGIP meetings. Our goal is to provide a forum for e exchange of ideas, and e opportunities for learning are endless. We were inspired by e discussion at a recent meeting following e initial data collection process, says Casmer. 19,  · PRI Y CARE PHYSICIANS Should work tods obtaining e BCBSM PCMH designation wi in one year of enrollment in PGIP. PCMH designation earns practices an additional valued based reimbursement (VBR) of –40 on E & M billing. New Advanced Care Practice recognition for additional 5 VBR beginning in . O er heal plans recognize PCMH designation . 15,  · Participate in e BCBSM Physician Group Incentive Program (PGIP) - PGIP representatives roughout Michigan meet quarterly and collaborate on initiatives designed to improve e heal care system in Michigan. PGIP meetings are open to representatives of physician organizations and Organized System of Care groups and invited guests. PGIP Quarterly Meeting. 6 Interest Groups Ad Hoc Projects Leadership Committees Initiatives (Core Teams) Physician Group Incentive Program (PGIP) Organizational Model Pri y Care Medical Oncology 1 Improvement Capacity Initiatives • BCBSM has assets at can be leveraged to achieve. In fact, e revamped and renamed PPPCAC (now known as e Professional Provider Relations Advisory Committee or PPRAC) kicked-off its inural meeting on February 11, wi a robust discussion on e Physician Group Incentive Program (PGIP), Patient-Centered Medical Home designation, tiered-fee uplifts and fee updates in , and coding. Current BCBSM Specialist Value-based Reimbursement Model. VBR applies to all professional relative value unit (RVU) based procedure codes and e anes esia time and base codes* VBR applies to commercial claims only. Specialists must be enrolled in PGIP to be eligible (must be in PGIP 1 year prior to receiving e VBR) Based on population. BCBSM chose to use ASCO's QOPI as e foundation for e PGIP oncology initiative because it was an established and nationally validated program. BCBSM recognized at e QOPI platform, developed by practicing clinicians, was an ideal foundation for quality improvement for oncology practices participating in PGIP. seq., and whe er e fees collected for BCBSM’s Physician Group Incentive Program (PGIP ) violated BCBSM’s fiduciary duties. For e reasons stated below, bo motions for partial sum y judgment will be granted in part. I. 1:16-cv- 317-TLL-PTM . Program (PGIP), Patient-Centered Medical Home (PCMH)-based infrastructure and care processes have been organized into 12 Domains of Function (listed in Table of Contents). Each PCMH Domain of Function has a set of required capabilities, collaboratively developed by BCBSM and PGIP Physician Organizations (POs). 25,  · presentation at e BCBSM PGIP Quarterly Meeting. Our Results. Achievements • Multiple PO groups in different stages of pilot projects • Presentations to over 500 physicians • Spring Scientific, Annual Scientific, HOD, Board of Directors, Executive Council of POs, HCQE2. Important Information About Medicare Plans 1996– Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of. e Physician Alliance. Physician changes – CIPA reports all Physician Group Incentive Program (PGIP) physician changes to Blue Cross Blue Shield of Michigan (BCBSM) on a quarterly basis rough its practitioner alignment online tool. Any physician leaving or joining a practice needs . Physicians who are organized into effective networks and coordinate and improve patient care be eligible for financial incentives including e Blue Cross Physician Group Incentive program (PGIP) and BCBSM Patient-Centered Medical Home (PCMH). 23,  · PRM is an administrative arm of OPR and would manage e BCBSM pa way program. Before e development of is partnership, BCBSM instituted a pay-for-performance program in 2005 for Michigan physicians, e Physician Group Incentive Program (PGIP). is program added a physician organization fee component to each professional service payment. Michigan (BCBSM. Detroit, MI), a large single-state not-for- physicians, e Physician Group Incentive Program (PGIP). Schedule quarterly committee meetings Keep e pa way up to date Validation Clinical staff validates all requested changes, ensuring proper references. 25,  · BCBSM reports at in all specialties except for anes esiology* will be eligible for fee uplifts in PGIP. e inclusion of specialists in BCBSM PGIP specialty fee uplifts is intended to help promote e evolution of e Patient-Centered Medical Home (PCMH) to e PCMH neighborhood (PCMH-N) in which specialists are actively engaged. DMC: www.dmc.org: Friends & Family: www.dmcfriendsandfamily.org: BCBSM PGIP: //www.bcbsm.com/provider/value_partnerships/pgip/initiatives.shtml: BCBSM PCMH. BCBSM Physician Group Incentive Program (PGIP) Organizations in MI x8,000 physicians, 1.8M beneficiaries $ 0 million annual state‐wide incentive pool Quarterly state‐wide meetings Physician Group Incentive Program. • 84 of PGIP PCPs are PCMH designated by BCBSM and receiving differential Physician Group Incentive Program (PGIP) Key Statewide Provider Initiatives at • CQI: In first quarter , CQI devoted entire quarterly meeting to discussion on opioids. Subsequently issued opioid use guidelines and protocol for weaning. zQuarterly 1-2 day sessions • • Assessing and meeting e needs of e patients • • Communicating across care settings • • Medication reconciliation BCBSM PGIP Ambulatory Care Sensitive Conditions: Inpatient Discharges / 00: 0 5 15 20 25 2006 2007 2008 2009. Physician Group Incentive Program.. Meet wi your Practice Resource Team (PRT) member at least quarterly. 2. Use your electronic registries at e point of care and perform patient outreach to improve quality. 6. Complete a practice PCMH self assessment validation survey twice a year wi PRT member. 7. Develop a plan to continue. Implementation of Cancer Clinical Care Pa ways. 18, . Bruce. Feinberg, DO, James Lang, PharmD, MBA, James Lang, PharmD, MBA. Reporting, Extracting and Analysis of Data – ACO, PCMH, CMS-GPRO, HEDIS, Pay for Performance, PRP, PGIP and numerous o er projects and audits.Title: Director of Provider Services at . -Analyzing & evaluating PGIP data (BCBSM claim driven) at is received mon ly, quarterly, and bi-annually. -Development of educational material for physician buy-in to increase e number of Title: Director of Practice .

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