Will changing your PO affiliation affect relationships with patients or incentive rewards?

David Share, M.D., M.P.H., Blue Cross Blue Shield of Michigan senior vice president, Value Partnerships, and Allison Pollard, Blue Care Network vice president, Provider Affairs, sent a letter on Feb. 20 to physician organizations participating in the Physician Group Incentive Program to answer a question that was on the minds of some physicians

Physicians asked: “Does changing my physician organization affiliation affect my relationships with patients or disrupt any potential rewards I may receive through Blue Cross Blue Shield of Michigan incentive programs?” The short answer is “no.” For more details, see the text of the letter below:

In response to recent inquiries, Blue Cross Blue Shield of Michigan and Blue Care Network (BCBSM/BCN) would like to provide clarity about some of our policies and expectations for POs that partner with us in our various programs. BCBSM/BCN, for all products and pay-for-performance programs, allows patients to continue their medical care with their physician of choice even if their physician decides to change physician organizations.

Patients (members) attributed to or assigned to physicians in a PO are not bound to that PO. Physicians within POs may exercise their right to change POs, without concern about disruption in their relationships with their patients. Physician’s patients may elect to continue to seek care with the same physician when the physician joins a new PO, or may choose to seek care with a new physician. The decision regarding whether patients remain with a physician is not at the discretion of the physician organization.

Additionally, physicians will not be negatively affected in regard to potential rewards in BCBSM incentive programs if they change physician organization affiliation. Physician-specific incentives are not linked to the physician organization and should a physician change POs during an incentive program year, BCBSM will apportion earned incentives based on the performance of each PO and the proportion of the year the physician was in each PO. The performance recognition payments made by BCN, BCNA and MAPPO are based on the performance of the individual physician and will be paid to the physician (or physician’s employer) at their relationship at the time of the incentive is paid.

We are confident that each physician organization will continue to work collaboratively with physicians and patients to maintain positive relationships that foster our mission. Thank you for your continued contributions and partnership with Blue Cross Blue Shield of Michigan and Blue Care Network.

Please direct questions to the appropriate individual listed for assistance.

Donna LaGosh, BCBSM, Manager, PGIP Field Team, 313-448-6058
Michael VanPutten, BCN, Director, Contracting, 616-956-5734
Jill Torok, BCN, Provider Affairs Operations Manager, 734-887-5414

Thanks for your partnership and attention to this matter.