BCBSM Pay For Performance (P4P)
P4P recognizes short-term acute-care hospitals for achievements and improvements in quality, cost efficiency, and population-health management.
The BCBSM 2024 Hospital Pay for Performance Peer Groups 1-4 guide is publicly accessible and updated annually.
CQI performance makes up a proportion of the available annual P4P payment.
Report Attestation Form links - available October 1, 2024
2023 Scorecards & Documentation
- PCI + VS Sites (Group #1-High volume EVAR & CEA VS sites)
- PCI + VS Sites (Group #2-Low volume EVAR VS sites)
- PCI + VS Sites (Group #3-Low volume CEA VS sites)
- PCI + VS Sites (Group #4-New VS sites)
- PCI-only Sites (Group #5)
- VS-only Sites (Group #6-High volume EVAR & CEA VS sites)
- VS-only Sites (Group #7-Low volume EVAR VS sites)
- VS-only Sites (Group #8-Low volume CEA VS sites)
- VS-only Sites (Group #9-New VS sites)
- 2023 Performance Index Supporting Documentation
BSBSM Value Based Reimbursement (VBR)
Blue Cross Blue Shield of Michigan has developed a Value-Based Reimbursement model that encourages physicians to provide cost-efficient care at both hospital and population levels.
For physicians being scored on PCI measures
Practitioners are grouped by their affiliated physician organization. The POs are evaluated on each measure individually and must achieve the performance target on all three measures to be considered eligible to receive the CQI VBR.
For practitioners being scored in VS measures
Practitioners are grouped by their affiliated hospital based on where the practitioners perform the greatest number of procedures. The hospitals' affiliated practitioners must achieve target at the hospital level both measures listed above to be considered eligible to receive the CQI VBR.
CQI VBR selection process
For a practitioner to be eligible for CQI VBR, they must:
- Meet the performance targets set by the coordinating center
- Be a member of a PGIP physician organization for at least one year
- Have contributed data to the CQI’s clinical data registry for at least two years, including at least one year of baseline data
Practitioners may receive up to 103 percent of the Standard Fee Schedule for performance in a single CQI. Practitioners who participate in BMC2-PCI and Michigan TAVR are eligible to receive up to 105 percent of the Standard Fee Schedule.
BMC2 VBR Goals
- 2025 PCI and VS Goals
- 2024 PCI and VS Goals
- 2023 PCI and VS Goals
- 2022 PCI and VS Goals
- 2021 PCI and VS Goals
- 2021 PCI Goals Revised
- 2020 PCI Goals
- 2020 Vascular Surgery Goals
Contact BMC2 for information on archived P4P Scorecards and VBR Goals at email@example.com