BCBSM PHYSICIAN GROUP INCENTIVE PROGRAM (PGIP)

Blue Cross Blue Shield of Michigan’s Physician Group Incentive Program (PGIP) supports and facilitates practice transformation using a wide variety of initiatives to reward physician organizations for improved performance in healthcare delivery. PGIP includes more than 40 Michigan POs, representing more than 19,000 primary care and specialty physicians who are members of the Blue Cross Blue Shield of Michigan TRUST PPO and/or Traditional Networks. These physicians provide care to nearly two million Blue Cross Blue Shield of Michigan members.

More than 1,800 UP physicians participate in PGIP.

PGIP encourages all payer collaboration, developing a single payer system, rather than having a payer-specific system based on the individual.

PGIP is an incentive program that catalyzes physicians to effectively manage their patient population and build an infrastructure to more robustly measure and monitor care quality. It is comprised of over 30 initiatives aimed at improving quality of care and increasing appropriate utilization of
services while maintaining patient-centered focus. The PGIP initiatives can be categorized into one of four categories: Condition-Focused, Service-Focused, Core-Clinical Process-Focused, and Clinical Information Technology-Focused.

Program Goals:

  • Transform systems of care to more effectively manage patient populations
  • Promote collaborative relationships amongst physicians and physician organizations
  • Achieve measurable savings in specified areas (Pharmacy, Imaging, etc.)
  • Reward physicians for improved performance and adoption of best practices in the cost-effective delivery of care while optimizing patient health outcomes

To consult on quality and process improvement or to align with UP for PGIP, contact Client Services at 248.593.0100 or clientservices@updoctors.com.