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PGIP Reward Pool Funding Process

Providers submits claims to BCBSM

BCBSM determines allowed amount for services rendered.

BCBSM calculates 5% PO Component from allowed amount and adds it to the PGIP reward tool. 

BCBSM process claims and sends out provider voucher. 

PGIP Physician Organization

Infrastructure

Support

Incentive Payment

BCBSM pays out entire reward pool to participating physicians organizations each program year. 

 

No monies are retained by BCBSM for administrative costs.

 

Payments are based on performance and utilization measures.  

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