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July 2017
Interested in joining PGIP? Here’s your chance
About PGIP
Now in its 12th year, PGIP is an innovative provider program developed with input from physicians across Michigan to help improve the quality and efficiency of health care in the state. PGIP facilitates change through nearly 20 initiatives, including our nationally recognized Patient-Centered Medical Home program. It offers incentives to participating physicians and physician organizations and organized systems of care for improving health care delivery.
About physician organizations
A PGIP physician organization consists of physicians working together to:
- Transform systems of care to effectively manage patient populations.
- Build infrastructure needed to optimize, measure and monitor quality of care.
POs work to promote collaborative relationships and support the most cost-effective delivery of services while optimizing patient outcomes.
About organized systems of care
An organized system of care is a community of caregivers with a shared commitment to quality and cost-effective health care delivery for a defined population. These caregivers have a shared commitment to:
- Deliver quality and cost-effective health care for a specific population.
- Provide care and treatment to a patient population attributed to the community’s primary care physicians.
- Join forces with one or more hospitals and other entities to share collective responsibility for a specific population of patients.
Here’s how participating network physicians, physician organizations and organized systems of care can get involved in the program that’s transforming health care in Michigan.
Blue Cross Blue Shield of Michigan encourages participating network physicians, organized systems of care and physician organizations to join the Physician Group Incentive Program. See information at right.
Network primary and specialty care physicians
- Can only join PGIP as part of a PGIP physician organization and must be affiliated with a PGIP physician organization to be a member of an OSC.
- Should contact a PGIP-participating PO directly to discuss specific membership criteria. Here’s a current list of the more than 40 PGIP physician organizations. (Each physician organization has its own criteria for membership. A physician can only be a member of one PO for the purposes of PGIP.)
Requirements
To participate in PGIP, a network physician must:
- Participate in the Blue Cross PPO, TRUST or Traditional lines of business.
- Be in good standing with the network.
- Be a medical doctor, doctor of osteopathy, doctor of chiropractic or doctor of podiatric medicine. Fully licensed psychologists are also eligible to participate in the program.
If you’re a physician with questions about participating in PGIP, contact your provider consultant. Not sure who that is? Check out the Contact Us section of bcbsm.com/providers.
POs and OSCs
- Blue Cross will accept applications from new POs and OSCs through Aug. 31, 2017.
Requirements
- If you represent a PO or an OSC and would like to complete an application to join PGIP, send an email to valuepartnerships@bcbsm.com.
- Be sure to specify whether you want to apply as a PO or an OSC.
For more information
Want more details? Check out the following webpages.
- Physicians: Information can be found on the following webpage: How to participate in PGIP
- Physician organizations: Information can be found on the following webpage: Join PGIP
- Organized systems of care: Information can be found on the following webpage: Models of Care
To learn more about PGIP, check out our bcbsm.com and valuepartnerships.com websites.
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