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.

• PGIP Basics

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.

• PCMH Fact Sheet

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 enhanced access to patient-centered, high-quality care.

• More on PCMH-N
• Other PGIP Opportunities for Specialists

The Blueprint for Affordability program, a value-based shared-risk contract through BCBSM, emphasizes the importance of population health management to overall lower cost of care, increase quality performance, and increase patient satisfaction. Including the BCBSM commercial and Medicare Advantage lines of business, the Blueprint for Affordability model helps physician organizations maintain predictable expenses for patients and physicians.

• Blueprint for Affordability Overview

BCBSM has partnered with the Michigan Institute for Care Management and Transformation (MiCMT) to support a statewide strategy to engage patients with chronic conditions through patient care teams. Supportive care teams include nurses, social workers, dietitians, pharmacists, community health workers, and other care team members who assist both primary care and specialist offices with services that support and promote the physician’s care plan and desired patient outcomes.

• PDCM Overview

Health Information Exchange (HIE) allows for health- and medical care-related information to be shared and accessed among healthcare physicians. Sharing this information allows physicians to exchange vital medical records regardless of where the patient is receiving care, whether local or distant hospitals and emergency rooms, specialists, radiology centers, or lab centers. Information can then be easily translated to notify care team members, including physicians and care managers, about the patient’s health.

• HIE Overview

• BCBSM Medicare Advantage PPO

• BCN Commercial
• BCN Advantage

• Medicaid

• HAP Commercial HMO
• Medicare Complimentary
• HAP PPO
• HAP POS
• Medicare Advantage
• HMO Senior Plus
• ASO
• HAP Empowered (Medicaid)

• HMPO
• PPO
• PFFS

• Commercial
• Medicaid (Including Healthy Michigan Plan)
• Health Advantage (PPO)
• McLaren Health Advantage
• McLaren Employed
• McLaren POS – Community Commercial
• McLaren Medicaid

• Meridian Medicaid
• WellCare Medicare
• Meridian Complete

• Medicaid
• Medicare

• HMO
• PPO
• Medicare
• Medicaid

• H&W (PPO)
• HMO
• Medicare Advantage
• Medicare Select