Value Partnerships

At Blue Cross, you're more than a provider; you're our collaborative partner. Through our Value Partnerships programs, we'll work together to make health care better for everyone.

Why our partnership matters

1.
It helps enhance the quality of care for all patient populations.
2.
By sharing best practices, we assist in improving patient outcomes.
3.
Collaboration helps make health care more cost effective.
4.
Your quality improvement gets recognized through meaningful incentive programs.

How it works

Value Partnerships is a unique, collaborative approach to improving health care and making it more cost effective.

By partnering with you and other providers and hospitals across Michigan, we share best practices to improve patient outcomes.

Hospital Pay-for-Performance

Blue Cross Blue Shield of Michigan has two hospital incentive-based programs. We call them pay-for-performance, or P4P. Both programs recognize hospitals that excel at care quality, cost-efficiency and population health management.

We split these programs up based on hospital size. Large- and medium-sized hospitals are referred to sometimes as peer groups 1-4. Small rural hospitals are sometimes called peer group 5.

Large and medium-sized hospitals

Large or medium-sized hospitals can earn up to an extra 5% toward their operating costs. Here’s some more information:

Small, rural hospitals

Small hospitals can show value to their community by meeting expectations for care access, quality and effectiveness. Here’s some more information:

Physician Group Incentive Program

The Physicians Group Incentive Program consists of more than 20,000 primary care and specialist physicians in Michigan involved in quality improvement efforts.

This program, which began in 2005, connects 40 physician organizations focused on improving the health care system in Michigan. This is accomplished through collaboration, sharing of best practices and data collection to increase the overall value of care while reducing costs. Participating organizations are evaluated and rewarded based on these outcomes:

  • Health care quality
  • Quality metric performance
  • Performance enhancement

More information about PGIP

Ready to join?

Application for PGIP (PDF)

Value-Based Reimbursement

Blue Cross Blue Shield of Michigan has developed a Value-Based Reimbursement model with two areas for earning. This approach encourages hospitals to work with physicians to provide cost-efficient care at both hospital and population levels.

We’re moving away from the fragmented, fee-for-service system to one that rewards collaboration and improvements.

Learn more with the Population Health Management Summary (PDF) and Frequently Asked Questions about Value-Based Reimbursement (PDF).

Reward opportunities

There are two opportunities for hospitals to earn rewards with Value-Based Reimbursement:

Hospital infrastructure funding (PDF)

Population-based performance (PDF)

Find out more about these two steps in the Value-Based Reimbursement Overview (PDF).

Population insights report

This program also provides a population insights report. The report gives you information about patient populations that you can use to:

  • Identify physician partners
  • Better understand current population-based performance
  • Begin conversations between hospitals and their physician partners

Take a look at the Population Insights Reporting (PDF) to see what kind of information you'll have access to.


Want to learn more?

Read more about the impact Value Partnerships has on health care.