We’re resuming distribution of value-based reimbursement reports

Select primary care physicians and specialists who participate in the Physician Group Incentive Program and meet the standards of specific PGIP quality programs are eligible for reimbursement under the Value-Based Reimbursement Fee Schedule. We wrote about the VBR fee schedule in the April Record.

The VBR Fee Schedule sets reimbursement rates for specific codes at greater than 100 percent of the TRUST/Traditional/BPP/EPO Maximum Fee Schedules, also called Standard Fee Schedules. We refer to reimbursement earned through our quality programs as “value-based reimbursement.”

In response to requests from PGIP physicians and physician organizations, we’re pleased to announce that we’re resuming distribution of reports of the estimated amount of value-based reimbursement received by practitioners. On an annual basis, each PO will receive a report of the estimated amount of value-based reimbursement received by each of the PGIP practitioners within the PO for the previous calendar year.

The next report will be distributed this month (October). The POs may share practitioner-specific information with the individual practitioners in the PO if they choose to.

For more information about PGIP and value-based reimbursement, check out the Value Partnerships Overview page of bcbsm.com/providers.