Hospital Pay for Performance

Blue Cross Blue Shield of Michigan has two hospital pay-for-performance programs which were developed to improve quality and cost within hospitals. The peer groups 1-4 program is designed for large and medium-sized acute care hospitals. The peer group 5 program is specifically designed for small rural hospitals.

If you’re a large or medium-sized hospital you may qualify to be rewarded for quality and efficiency. Through the pay-for-performance program, a top-performing hospital can earn up to an additional 5 percent of its inpatient and outpatient operating payments. Here is some more information:

• A detailed description of the 2013 pay-for-performance program (PDF)
• A detailed description of the 2012 pay-for-performance program (PDF)
• 2013 Index Measures for Collaborative Quality Initiatives (PDF)
  
• 2012 index measures for collaborative quality initiatives — updated June 2012 (PDF)
• 2011 Performance Thresholds (PDF)
• 2012 peer groups 1-4 attestation form (PDF)
• 2012 peer groups 1-4 quality indicators performance report (PDF)

If you’re a small rural hospital that provides your community with access to high-quality health care, you may qualify for a peer group 5 pay-for-performance program. Here is some more information:

• 2012-2013 peer group 5 attestation form (PDF)
• 2013-2014 detailed description of the peer group 5 pay-for-performance program (PDF)
• 2012–2013 detailed description of the peer group 5 pay-for-performance program (PDF)
• 2012-2013 performance thresholds for critical access hospitals (PDF)
• 2012-2013 performance thresholds for non-critical access hospitals (PDF)

If you have questions about our hospital pay-for-performance program, please contact us.