Blue Cross Blue Shield of Michigan rewards PGIP physician organizations and Organized Systems of Care for system transformation and population level management twice a year.
What you need to know about incentive rewards
An organization’s reward depends on:
- Performance and improvement
- Accomplishing goals with its PGIP physicians
Each organization can decide how to use their reward. For example, some develop infrastructure or give incentives to physicians. We expect them to use the money to further the PGIP goals of improving health care quality and transforming health care value.
All funds from the PGIP reward pool go to the physician organizations and Organized Systems of Care. Blue Cross Blue Shield of Michigan doesn’t keep any funds to cover administrative costs.
How we fund the PGIP reward pool
Most professional fees have two parts:
- The physician component, which honors our commitment to reimburse allowed amounts to individual physicians.
- The PGIP physician organization component, which is a percentage, currently set at 5 percent of the allowed amount for most professional services. This funds the PGIP reward pool for disbursement to physician organizations and Organized Systems of Care.