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Physician Group Incentive Program (PGIP): Expectations

Incentive Rewards

This program includes payment to physician organizations for participation and performance improvement in the initiatives selected. Most physician organizations are eligible for both components, depending on the incentive design of the particular initiatives.


Participation Reward

Physician organization participation includes involvement in leadership, collaboration with other physician organizations, recruitment of new participants, and the development of new initiatives and projects with BCBSM. Physician organizations may be eligible to receive participation rewards to cover their time, effort and investment in these activities. Leadership opportunities include participation in the following:

  • Initiative Teams
  • Leadership Committees
  • Project Teams
  • Voluntary Interest Groups

Performance Reward

The performance payment rewards success in achieving measurable goals as defined in the initiative(s) the physician organization participates in for that program year.


Funding the Pool & Distributing Payment

For services subject to the TRUST PPO fee schedule, BCBSM will fund the physician incentive reward by reserving a portion (3.1 percent as of July 1, 2009) of the physician fee for most procedure codes (anesthesiology services, immunizations, durable medical equipment, prosthetics and orthotics, and most injections are not included).


A sample schedule for reward pool accrual payments is provided below.


Schedule for the reward pool accrual and payment distribution for 2009:


Reward Pool Accrual December 2008 through May 2009 June 2009 through November 2009
Payment Distribution July 2009 January 2010