Managed Care Incentive Programs
PMC has contracts with more than 10 health plans that provide generous incentives aimed at improving the quality, efficiency, and overall value of health care. The purpose of these programs is to encourage providers to carry out improvements and to achieve optimal outcomes for patients. For more information on these programs, please contact your designated Practice Consultant. Click here for our list of Health Contracts
Blue Cross Blue Shield of Michigan (BCBSM)
Physician Group Incentive Program (PGIP)
The BCBSM Physician Group Incentive Program (PGIP) supports and facilitates practice transformation using a wide variety of initiatives to reward physician organizations for improved performance in health care delivery. Through PGIP, BCBSM is helping to improve the quality of care so it is provided reliably to all patients, all of the time.
Patient-Centered Medical Home Initiatives (PCMH)
Patient-Centered Medical Home (PCMH) is a health care model led by a primary care physician that focuses on the health needs of each patient, coordinates patient care across all settings, and provides enhanced access to care.
Patient-Centered Medical Home – Neighbor Program (PCMH-N)
The Patient-Centered Medical Home – Neighbor Program (PCMH-N) works collaboratively with the PCMH care model, and encourages specialists to adopt practices and capabilities in line with the PCMH. A PCMH-N practice engages in processes that ensure effective coordination and integration with PCMH practices, ensures efficient flow of information, and supports the enhanced access to patient-centered, high-quality care.
Other PGIP Opportunities for Specialists
Organized Systems of Care (OSC)
BCBSM is working collaboratively with physician organizations and hospitals across Michigan to develop Organized System 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 and will take BCBSM’s PCMH program to the next level.
Centers for Medicare & Medicaid Services (CMS)
Comprehensive Primary Care Plus (CPC+)
Comprehensive Primary Care Plus (CPC+) is a national advanced primary care medical home model that aims to strengthen primary care through regionally-based multi-payer payment reform and care delivery transformation. CPC+ payment redesign gives practices the additional financial resources and flexibility they need to make investments that will improve quality of care and reduce the number of unnecessary services their patients receive.
Great Lakes Practice Transformation Network (GLPTN)
An initiative of the CMS Transforming Clinical Practice Initiative
Backed by funding from the Centers for Medicaid and Medicare Services’ (CMS) Transforming Clinical Practices Initiative (TCPI), GLPTN aims to guide 15,000+ clinicians to achieve large-scale health transformations through collaborative and peer-based learning networks. GLTPN is a groundbreaking collaboration among 36 partners – universities, health systems and independent provider-practices – designed to transform the way health care is administered to patients.
Transforming Clinical Practice Initiative
State Innovation Models (SIM)
The Michigan Department of Health and Human Services (MDHHS) has received a $70 million grant from the U.S. Department of Health and Human Services to develop and test models outlined in the blueprint for Health Innovation over the next four years. The aim is to develop and test a multi-payer health care payment and service delivery model in order to achieve better care coordination, lower costs, and improved health outcomes for patients.