We invite you to join PGIP as an organized system of care

Blue Cross Blue Shield of Michigan encourages our participating network physicians and organized systems of care to get involved in the Physician Group Incentive Program.

PGIP has been improving the quality and efficiency of health care in Michigan for more than 12 years. That’s why we’re pleased to announce that we’ll accept applications from new OSCs from April 1 through April 30, 2019.

OSCs that apply before the April 30 deadline and are accepted into the program will be eligible to participate in PGIP’s new PPO risk program for OSCs, starting in 2020. We’ll provide more details about the program in future editions of The Record.

About organized systems of care: An OSC is a community of caregivers with a shared commitment to quality and cost-effective health care delivery for a defined population. These caregivers have committed to:

• Deliver high-quality, 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 defined population of patients.

For more details about OSCs, visit the Models of Care section of our website.

If you represent an OSC and would like to join PGIP, send an email to valuepartnerships@bcbsm.com.

About physician organizations: A PGIP physician organization consists of physicians working together to:

• Transform systems of care to effectively manage patient populations.
• Build the infrastructure needed to optimize, measure and monitor quality of care.

Physician organizations promote collaborative relationships and support the most cost-effective delivery of services to improve patient outcomes.

Here’s the criteria for physicians joining PGIP:

Network primary and specialty care physicians

• They can only join as part of a PGIP physician organization and must be affiliated with a PGIP physician organization to be a member of an organized system of care.
• They should contact a PGIP-participating physician organization 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 physician organization for the purposes of PGIP.

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, doctor of podiatric medicine, or fully licensed psychologist.

If you’re interested in participating in PGIP as an individual practitioner, send an email to valuepartnerships@bcbsm.com.

More information

About PGIP: 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 approximately 20 initiatives, including our nationally recognized Patient-Centered Medical Home program. It offers incentives to participating physicians, physician organizations and organized systems of care for improving health care delivery. For more information, visit valuepartnerships.com.