The Blue Cross Blue Shield of Michigan (BCBSM) Hospital Pay-for-Performance (P4P) Program rewards hospitals that excel at care quality, cost-efficiency, and population health management. Beginning in 2018, BCBSM allocated 10% of its P4P program budget to an episode of care spending metric based on MVC data. In designing and implementing the MVC Component of the BCBSM P4P Program, MVC endeavors to achieve fairness, measure validity, transparency, alignment with BCBSM and CMS quality measures, and a meaningful impact on quality improvement.
One Program Year (PY) of the MVC Component of the P4P Program occurs over multiple calendar years; in a given PY, MVC collects hospital claims data from a baseline year and performance year, begins assessment of this data and provides final scores for payment during a scoring year. In addition, the program follows two-year cycles, using the same structure and scoring methodology for all activities related to that cycle’s two PYs.
In calendar year 2025, for example, hospitals will receive their final scorecards and payment for PY 2024, their assessment for PY 2025 will begin with mid-year scorecards expected in Q3, and they will care for the patients comprising their performance year data for PY 2026.
Supplemental Resources
PY25 Engagement Point Menu & Dates
PY25 engagement point offerings and event dates. PY25 is scored out of 10 points, with up to 2 points awarded for completing activities in 2025 from the engagement point menu. There are no bonus points in PY25.
Technical Document: PYs 2026-2027
Program overview of the structure, methodology, cohorts, and more for Program Years 2026-2027.
Cohorts for PYs 2026-2027
PY 2026-2027 cohort groupings for the main conditions (CHF, COPD, pneumonia, preoperative testing, and sepsis), CABG, and PCI.
PYs 2026-2027 Episode Spending & Value Metric Selections
Episode spending and value metric selections by hospital for PYs 2026-2027.
PYs 2026-2027 FAQ
Frequently asked questions on the MVC Component of the BCBSM P4P Program for PYs 2026-2027.
Technical Document: PYs 2024-2025
Program overview of the structure, methodology, cohorts, and more for Program Years 2024-2025.
Cohorts for PYs 2024-2025
MVC cohorts for PY 2024-2025 episode spending and value metric measures.
PYs 2024-2025 Value Metric Selections
Value metric selections by hospital for PYs 2024-2025.
PYs 2024-2025 Episode Spending Selections
Episode spending selections by hospital for PYs 2024-2025.
P4P Targets: Why MVC Doesn't Freeze
Learn the rationale behind MVC's decision not to freeze targets for P4P metrics, including a sample scoring scenario.