The Value Partnerships Program at Blue Cross Blue Shield Michigan (BCBSM) develops and maintains quality programs to align practitioner reimbursement with quality of care standards, improved health outcomes and controlled health care costs. Practitioner reimbursement earned through these quality programs is referred to as value-based reimbursement, or VBR. The VBR Fee Schedule sets fees at greater than 100% of the Standard Fee Schedule.

 

Recently, the Value Partnerships Program expanded their VBR opportunities to Physician Group Incentive Program (PGIP) practitioners who participate in select Collaborative Quality Initiatives (CQIs) and meet specific eligibility criteria. Eligible practitioners receive 103-110% of the standard fee schedule as part of “CQI VBR”.

 

Currently, MROQC is one of 13 CQIs to offer participating PGIP physicians the opportunity to receive CQI VBR, based on meeting clinical targets relevant to MROQC. MROQC, in collaboration with BCBSM has developed quality and performance metrics for MROQC’s value-based reimbursement.

 

For an MROQC radiation oncologist to be eligible for CQI VBR, their facility must:

• Meet the performance targets set by the consortium

• The radiation oncologist themselves must be a member of a PGIP physician organization for at least one year

• Have contributed data to the MROQC's data registry for at least two years, including at least one year’s worth of baseline data