Dear Medical Care Group Business Administrator:
Blue Cross Blue Shield of Michigan and Blue Care Network are happy to share our 2023 Quality Rewards booklet (attached) which contains information about the 2023 Performance Recognition Program and the Physician Group Incentive Program. Copies will be available in the Resources section of BCN Health e-BlueSM and BCBSM Medicare Advantage Health e-Blue in the next few days. You can also find it on the PGIP Collaboration website by the following path: Initiatives/Projects/Workgroups > Quality Rewards (CLQI, CQ VBR, PRP) under General Documentation.
The 2023 Quality Rewards describes reward opportunities for:
- Blue Cross commercial PPO (for PGIP participants)
- Medicare Plus BlueSM (often referred to as Medicare Advantage PPO)
- Blue Care Network commercial HMO
- BCN AdvantageSM
Here are some highlights of changes in the 2023 quality rewards:
|
Program |
Measures Removed |
Measures Added |
|
Commercial HMO Performance Recognition Program |
None removed |
Two added: |
|
|
· Diabetes Care – Blood Pressure Control |
|
|
|
· Immunizations for Adolescents - HPV |
|
|
Medicare Advantage Performance Recognition Program |
None removed |
One added: |
|
|
· Follow-up after ED visit for High Risk Multiple Chronic Conditions |
|
|
Clinical Quality - Value Based Reimbursement Program (PPO measures) |
None removed |
One added: |
|
|
· Immunizations for Adolescents - HPV |
|
|
Clinical Quality - Value Based Reimbursement Program (MAPPO measures) |
None removed |
None added |
|
|
|
|
|
|
|
As always, please remember that data entry into Health e-Blue must be for services rendered, not just ordered or reminders sent.
If you have any questions, please contact your provider consultant or your PGIP field team representative.