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 physicians to carry out improvements and to achieve optimal outcomes for patients. For more information on these programs, please contact us at (800) 594-6115. You may also contact our representatives online at your convenience by emailing us at PMCMembership@MedicalAdvantage.com.
Blue Cross Blue Shield of Michigan (BCBSM)
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 (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.
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.
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.
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.
Centers for Medicare & Medicaid Services (CMS)
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.
PMC Health Plan Contracts
PMC manages contracts with 10+ health plans for over 32 health products – giving PMC member physicians the benefit of negotiated contracts that provide generous incentives aimed at improving the quality, efficiency, and overall value of health care. For more information on these programs, please contact your PMC Consultant.
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- 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
To learn more about the Managed Care Incentive Programs at Professional Medical Corporation (PMC), please contact us at (800) 594-6115. Our knowledgeable team is available to provide you with detailed information and address any questions you may have regarding our Managed Care Incentive Programs. Feel free to reach out to us, and we'll be delighted to assist you.