Jump to Content

Physician Group Incentive Program (PGIP): Expectations

What's expected of program participants?

Be collaborative

Participating physician organizations are expected to work with representatives of other PGIP physicians organizations, become involved in common interest groups, and engage in one-on-one meetings and site visits to share experience.

Attend quarterly program meetings

PGIP meetings are currently held four times a year, alternating between Detroit and Lansing. For a complete listing of PGIP-related events, visit the Events page.

Provide a list of participating physicians

Physician organizations applications must include:

  • An electronic list of physicians participating in the program.
  • Physician list must be submitted electronically using a template provided by BCBSM.
  • In preparation for potential differential fee schedules associated with the Patient-Centered Medical Home, physician organizations will need to develop the capability to categorize practitioners by practice unit for billing purposes.
  • Practice units are defined as practitioners with common care processes and a commitment to serve a common patient population. They may practice at a common site, but this is not required.

A physician may be eligible to join the program by:

  • being board certified in one of the defined specialties,
  • participating with BCBSM TRUST PPO,
  • and being in good standing with the network (e.g., not currently under Corrective Action review).

Set annual goals

The physician organization annually chooses and prioritizes which PGIP initiatives it will work on each program year. Physician organizations should select goals that will expand their capacity to address the health care needs of the patient population they serve.

Report your progress

Physician organizations participating in PGIP are expected to:

  • Provide progress reports, self-assessments, and implementation plans to BCBSM at the end of February, July, and October of each year.
  • These reports specify investments, achievements, progress towards goals, and measurable results of initiatives selected as compared to the previous period. This may also include a summary of how previously distributed incentive dollars were used.
  • Complete other periodic surveys, such as a Business Model survey or Technical Capabilities survey.