2025 MISHC TAVR VBR Metrics Approved by Blue Cross Blue Shield of Michigan

The 2025 MISHC TAVR Value Based Recognition (VBR) Metrics have been approved by Blue Cross Blue Shield of Michigan and will be effective January 1st, 2024.

Process for confirming VBR site-specific measures:

  1. Sites submit a MISHC QI Project form (under the General Resources tab) by October 1, 2023. Copy both primary site coordinator and physician champions on submission email to sfields@med.umich.edu.

    Please include:

    a. Performance as of 2023 Q1 (baseline) on the proposed measure
    b. The target performance. The performance will be scored based on 2024 Q2 data.
     

  2. The MISHC Coordinating Center will notify the primary site coordinator and physician champions of project approval by November 1, 2023.

You will find more details below and can also access them on mishc.org under “Quality Improvement” and “Performance Indexes” and then MISHC VBR Goals. Thank you for your input in choosing these goals and for your unwavering commitment to improving quality of care and outcomes for patients in Michigan.

A chart outlining the 2025 MISHC TAVR VBR goals. Increasing referral to cardiac rehabilitation after Tavr to greater than or equal to 90%. Increase rate of mean gradient documenation at TAVR 1 year follow up at great than 75%. A site-specific measure with a site-specific goal.

 MISHC scoring methodology

  • MISHC TAVR uses a site-level scoring model to measure performance.
  • The site average must meet the target for 2 of 3 measures for practitioners to be eligible for VBR. Eligible practitioners may receive up to 103% of the Standard Fee Schedule.
  • Practitioners may receive an additional 102% of the Standard Fee Schedule for performance >1 CQI (BMC2 PCI or MSTCVS-QC; total = 105%).
  • The measurement period uses 2024 data and will be paid out in 2025.

 

CQI VBR selection process

For a practitioner to be eligible for CQI VBR, they must:

  • Meet the performance targets set by the coordinating center
  • Be a member of a PGIP physician organization for at least one year
  • Have contributed data to the CQI’s clinical data registry for at least two years, including at least one year of baseline data

A physician organization nomination isn’t required for CQI VBR. Instead, the CQI coordinating center will determine which practitioners have met the appropriate performance targets and will notify Blue Cross.

Each physician organization will notify practitioners who will receive CQI VBR, as it does for other specialist VBR.