Corrective action affects your value-based reimbursement eligibility

Value Partnerships continues to identify innovative models to reward practitioners who improve the quality of care for members and Michigan residents. However, those in corrective action because of utilization issues may be ineligible for value-based reimbursements until amends are made.

For a designated period, doctors and specialists who participate in the Physician Group Incentive Program and meet the applicable standards of quality programs developed under PGIP receive reimbursement in accordance with the Value-Based Reimbursement Fee Schedule.

For more information

For more information about the PPO Network Management corrective action process, see the November 2012 Record article TRUST PPO network information in review.

For details on the value-based reimbursement criteria, see the following April 2016 Record articles:

• Here's what you need to know about participating in Value Partnerships quality programs
• We’re making some changes to the Value-Based Reimbursement Fee Schedule, effective July 1, 2016

If you have questions, email valuepartnerships@bcbsm.com.