Over the past several years, MSMS and Michigan Osteopathic Association (MOA) leadership and staff have met regularly with key Blue Cross Blue Shield of Michigan (BCBSM) leaders and staff through the TriStaff and Physician and Participating Provider Contract Advisory Committee (PPPCAC) meetings. Although Blue Cross Blue Shield of Michigan’s (BCBSM) committee structure was streamlined during its organization as a mutual company, this access will not be compromised. In fact, the revamped and renamed PPPCAC (now known as the Professional Provider Relations Advisory Committee or PPRAC) kicked-off its inaugural meeting on February 11, 2014, with a robust discussion on the Physician Group Incentive Program (PGIP), Patient-Centered Medical Home designation, tiered-fee uplifts and fee updates in 2014, and coding and documentation accuracy.
Comprised of five BCBSM Board Members, three representatives from MSMS and two representatives from MOA, the PPRAC reports to the BCBSM Health Care Delivery board-level committee. The PPRAC provides a venue to discuss major areas of concern and interest between BCBSM and physicians. Additionally, MSMS leadership advocates the physician perspective on issues including but not limited to:
- BCBSM professional provider contracts
- BCBSM products
- Various administrative and care-related issues
- Medical necessity criteria and guidelines
- Reimbursement issues
- Physician supervision of services
The PPRAC meets quarterly. In the fall, the PPRAC will have a joint meeting with the Participating Hospital (PHAAC) focused on alignment opportunities of mutual interest to the physician and hospital communities. In-between these meetings, TriStaff meets monthly to address timely issues, some of which may be elevated for discussion by the PPRAC.
If you would like to know more about the PPRAC, contact Rebecca J. Blake at (517) 336-5729 or firstname.lastname@example.org.