Value Based Reimbursement (VBR)
Blue Cross Blue Shield of Michigan has developed a Value-Based Reimbursement model which encourages hospitals to work with physicians to provide cost-efficient care at both hospital and population levels. For more information, see their website.
2028
2027
2026
2025
2024
2023
2022
2021
2028
2028 VBR Measurement Period
Measurement Period: October 1, 2026 – September 30, 2027
Supplemental Documents
ASPIRE Value-Based Reimbursement (VBR) Program
ASPIRE VBR eligibility is based on hospital-level performance for a designated set of quality measures each year.
Performance is determined using:
- Hospital-level performance on the quality measures included in the 2028 ASPIRE VBR Program.
- Assignment of each provider to a Primary Hospital, based on where they perform the majority of their anesthetic cases during the measurement period.
Departments can monitor measure performance throughout the measurement period using the MPOG Quality Improvement Reporting Tool. Providers interested in accessing these dashboards should contact their site’s Quality Champion or Anesthesiology Clinical Quality Reviewer (ACQR).
Provider Eligibility
To be eligible for an ASPIRE VBR, anesthesiologists must:
- Practice at a participating ASPIRE hospital that meets the ASPIRE VBR performance thresholds as outlined on the scorecard linked below.
- Note: Providers who practice at more than one ASPIRE hospital will be assigned to the hospital where they perform the majority of their anesthetic cases during the measurement period. This Primary Hospital assignment will be used to determine VBR eligibility.
- Practice at a participating ASPIRE hospital that meets the ASPIRE VBR performance thresholds as outlined on the scorecard linked below.
- Meet BCBSM eligibility requirements, including being credentialed as an anesthesiologist within the BCBSM PPO network and/or participating in a BCBSM-affiliated Physician Organization during the applicable eligibility period.
BCBSM validates provider eligibility as part of the annual VBR approval process.
Questions regarding BCBSM eligibility should be directed to CQIprograms@bcbsm.com
2027
Eligibility:
- Performance calculated at hospital level – providers practicing at more than one hospital are assigned to the hospital where they performed the most cases
- Must be contracted with BCBSM’s PPO network and credentialed appropriately in anesthesiology or is in an affiliated BCBSM PGIP Physician Organization
- NOTE: BCBSM will validate eligibility by assessing if the provider is listed as a contracted provider from January 7, 2026 and through February 2027.
Increase in fee schedule:
- 3% – aggregate hospital performance met for 2 / 3 measures.
- 5% – aggregate hospital performance met for 3 / 3 measures
| Measure | Measurement Period | Target Performance |
|---|---|---|
| GLU-11: Percentage of cases with perioperative glucose >180 mg/dL with administration of insulin within 90 minutes of original glucose measurement. Measure Specification | 10/1/2025 – 9/30/2026 | ≥65% |
| SUS-02: Percentage of cases where carbon dioxide equivalents normalized by hour for cases receiving halogenated agents and/or nitrous oxide is less than CO2 eq of 2% sevoflurane at 2L FGF = 2.83 kg CO2/hr during the maintenance period of anesthesia OR the total CO2 equivalents is less than 2.83 kg CO2. Measure Specification | 10/1/2025 – 9/30/2026 | ≥60% |
| TEMP 03: Percentage Of patients requiring general or neuraxial anesthesia for whom a body temperature >= 36 degress Celsius (or 96.8 degrees Fahrenheit) was not recorded within 30 minutes before to 15 minutes after anesthesia end time (inverse measure). Measure Specification | 10/1/2025 – 9/30/2026 | ≤4.5% |
Smoking Cessation VBR Measures (in addition to standard VBR)
Eligibility:
- Standard VBR rules apply (see above)
Increase in fee schedule:
- Additional 2% increase
| Measure | Measurement Period | Target Performance |
|---|---|---|
| SMOK-01: Percentage of patients, ≥18 years of age, with smoking status documented within 365 days prior to any procedure requiring anesthesia. Measure Specification | 10/1/2025 – 9/30/2026 | ≥85% (12-month average) |
| SMOK-02: Percentage of patients, ≥18 years of age, who are documented as current tobacco smokers and also receive an approved smoking cessation intervention from an anesthesia provider. Measure Specification | 10/1/2025 – 9/30/2026 | ≥55% (12-month average) |
2026
Eligibility:
- Have at least 2-years of data in MPOG
- Performance calculated at hospital level – providers practicing at more than one hospital are assigned to the hospital where they performed the most cases
Increase in fee schedule:
- 3% – aggregate hospital performance met for 2 / 3 measures.
- 5% – aggregate hospital performance met for 3 / 3 measures
| Measure | Measurement Period | Target Performance |
|---|---|---|
| GLU-11: Percentage of cases with perioperative glucose >180 mg/dL with administration of insulin within 90 minutes of original glucose measurement. Measure Specification | 10/1/2024 – 9/30/2025 | ≥55% |
| SUS-02: Percentage of cases where carbon dioxide equivalents normalized by hour for cases receiving halogenated agents and/or nitrous oxide is less than CO2 eq of 2% sevoflurane at 2L FGF = 2.83 kg CO2/hr during the maintenance period of anesthesia OR the total CO2 equivalents is less than 2.83 kg CO2. Measure Specification | 10/1/2024 – 9/30/2025 | ≥50% |
| PONV-05: Percentage of patients who had a procedure requiring general anesthesia or cesarean delivery and receiving appropriate prophylaxis for postoperative nausea and vomiting. Measure Specification | 10/1/2024 – 9/30/2025 | ≥60% |
Smoking Cessation VBR Measures (in addition to standard VBR)
Eligibility:
- Standard VBR rules apply (see above)
Increase in fee schedule:
- Additional 2% increase
| Measure | Measurement Period | Target Performance |
|---|---|---|
| SMOK-01: Percentage of patients, ≥18 years of age, with smoking status documented within 365 days prior to any procedure requiring anesthesia. Measure Specification | 10/1/2024 – 9/30/2025 | ≥80% (12-month average) |
| SMOK-02: Percentage of patients, ≥18 years of age, who are documented as current tobacco smokers and also receive an approved smoking cessation intervention from an anesthesia provider. Measure Specification | 10/1/2024 – 9/30/2025 | ≥50% (12-month average) |
2025
Eligibility:
- Participating specialist must be contracted with BCBSM’s PPO prior to the VBR effective date of 3/1/2025
- Have at least 2-years of data in MPOG
- Performance calculated at hospital level – providers practicing at more than one hospital are assigned to the hospital where they performed the most cases
Increase in fee schedule:
- 3% – aggregate hospital performance met for 2 / 3 measures
- 5% – aggregate hospital performance met for 3 / 3 measures
| Measure | Measurement Period | Target Performance |
|---|---|---|
| TEMP 02: Percentage of cases receiving general anesthesia that had at least one core temperature documented intraoperatively. Measure Specification | 10/1/2023 – 9/30/2024 | ≥80% |
| SUS 02: Percentage of cases where carbon dioxide equivalents normalized by hour for cases receiving halogenated agents and/or nitrous oxide is less than CO2 eq of 2% sevoflurane at 2L FGF = 2.83 kg CO2/hr during the maintenance period of anesthesia OR the total CO2 equivalents is less than 2.83 kg CO2. Measure Specification | 10/1/2023 – 9/30/2024 | ≥40% |
| PONV 05: Percentage of patients who had a procedure requiring general anesthesia or cesarean delivery and receiving appropriate prophylaxis for postoperative nausea and vomiting. Measure Specification | 10/1/2023 – 9/30/2024 | ≥50% |
Smoking Cessation VBR Measures (in addition to standard VBR)
Eligibility:
- Standard VBR rules apply (see above)
Increase in fee schedule:
- Additional 2% increase
| Measure | Measurement Period | Target Performance |
|---|---|---|
| SMOK 01: Percentage of patients, ≥18 years of age, with smoking status documented within 30 days prior to any procedure requiring anesthesia. Measure Specification | 10/1/2023 – 9/30/2024 | ≥75% (12-month average) |
| SMOK 02: Percentage of patients, ≥18 years of age, who are documented as current tobacco smokers and also receive an approved smoking cessation intervention from an anesthesia provider. Measure Specification | 10/1/2023 – 9/30/2024 | ≥10% (12-month average) |
2024
Eligibility:
- Participating specialist must be contracted with BCBSM’s PPO prior to the VBR effective date of 3/1/2024
- Have at least 2-years of data in MPOG
- Performance calculated at hospital level – providers practicing at more than one hospital are assigned to the hospital where they performed the most cases
Increase in fee schedule:
- 3% – aggregate hospital performance met for 2 / 3 measures
- 5% – aggregate hospital performance met for 3 / 3 measures
| Measure | Measurement Period | Target Performance |
|---|---|---|
| GLU 03: Percentage of cases with perioperative glucose > 200 mg/dL with administration of insulin or glucose recheck within 90 minutes of original glucose measurement. Measure Specification | 12/1/2022 – 9/30/2023 | ≥78% |
| PAIN 02: Percentage of patients ≥ 18 years old who undergo a surgical or therapeutic procedure and receive a non-opioid adjunct preoperatively and/or intraoperatively. Measure Specification | 12/1/2022 – 9/30/2023 | ≥85% |
| SUS 01: Percentage of cases with mean fresh gas flow equal to, or less than 3L/min, during administration of halogenated hydrocarbons and/or nitrous oxide. Measure Specification | 12/1/2022 – 9/30/2023 | ≥85% |
Smoking Cessation VBR Measures (in addition to standard VBR)
Eligibility:
- Standard VBR rules apply (see above)
Increase in fee schedule:
- Additional 2% increase
| Measure | Measurement Period | Target Performance |
|---|---|---|
| SMOK 01: Percentage of patients, ≥18 years of age, with smoking status documented within 30 days prior to any procedure requiring anesthesia. Measure Specification | 12/1/2022 – 9/30/2023 | ≥70% (12-month average) |
| Proportion of current smokers that have smoking treatment offered SMOK 02: Percentage of patients, ≥18 years of age, who are documented as current tobacco smokers and also receive an approved smoking cessation intervention from an anesthesia provider. Measure Specification | 12/1/2022 – 9/30/2023 | ≥10% (best month) |
2023
Eligibility:
- Member of a Physician Organization for at least 1-year
- Have at least 2-years of data in MPOG
Increase in fee schedule:
- 3% – aggregate hospital performance met for 2 / 3 measures
- 5% – aggregate hospital performance met for 3 / 3 measures
| Measure | Measurement Period | Target Performance |
|---|---|---|
| GLU 03: Percentage of cases with perioperative glucose > 200 mg/dL with administration of insulin or glucose recheck within 90 minutes of original glucose measurement. Measure Specification | 12/01/21 – 11/30/22 | ≥65% |
| PAIN 02: Percentage of patients ≥ 18 years old who undergo a surgical or therapeutic procedure and receive a non-opioid adjunct preoperatively and/or intraoperatively. Measure Specification | 12/01/21 – 11/30/22 | ≥70% |
| SUS 01: Percentage of cases with mean fresh gas flow equal to, or less than 3L/min, during administration of halogenated hydrocarbons and/or nitrous oxide. Measure Specification | 12/01/21 – 11/30/22 | ≥80% |
New Smoking Cessation VBR Measures (in addition to standard VBR)
Eligibility:
- Must meet 2 out of 2 measures
Increase in fee schedule:
- Additional 2% increase
| Measure | Measurement Period | Target Performance |
|---|---|---|
| Smoking Status Documented within 30 days prior to surgery | 12/01/21 – 11/30/22 | ≥70% |
| Proportion of current smokers that have smoking treatment offered | 12/01/21 – 11/30/22 | ≥10% |
2022
Eligibility:
- Member of a Physician Organization for at least 1-year
- Have at least 2-years of data in MPOG
Increase in fee schedule:
- 3% – aggregate hospital performance met for 2 / 3 measures
- 5% – aggregate hospital performance met for 3 / 3 measures
| Measure | Measurement Period | Target Performance |
|---|---|---|
| GLU 03: Percentage of cases with perioperative glucose > 200 mg/dL with administration of insulin or glucose recheck within 90 minutes of original glucose measurement. Measure Specification | 12/01/20 – 11/30/21 | ≥70% |
| BP 03:Percentage of cases where intraoperative hypotension (MAP < 65 mmHg) was sustained for less than 15 minutes. Measure Specification | 12/01/20 – 11/30/21 | ≥85% |
| SUS 01: Percentage of cases with mean fresh gas flow equal to, or less than 3L/min, during administration of halogenated hydrocarbons and/or nitrous oxide. Measure Specification | 12/01/20 – 11/30/21 | ≥85% |
2021
Eligibility:
- Member of a Physician Organization for at least 1-year
- Have at least 2-years of data in MPOG
Increase in fee schedule:
- 3% – aggregate hospital performance met for 2 / 3 measures
- 5% – aggregate hospital performance met for 3 / 3 measures
| Measure | Measurement Period | Target Performance |
|---|---|---|
| PUL 02: Percentage of cases with median tidal volumes less than or equal to 8 ml/kg. Measure Specification | 1/1/2020 – 11/30/2020 | ≥85% |
| TEMP 03: Percentage of patients, regardless of age, who undergo surgical or therapeutic procedures under general or neuraxial anesthesia of 60 minutes duration or longer for whom no body temperature was greater than or equal to 36 degrees Celsius (or 96.8 degrees Fahrenheit) recorded within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time. Measure Specification | 1/1/2020 – 11/30/2020 | ≤5% |
| PONV 01: Percentage of patients, aged 18 years and older, who undergo a procedure under an inhalational general anesthetic, AND who have three or more risk factors for post-operative nausea and vomiting (PONV), who receive combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively or intraoperatively. Measure Specification | 1/1/2020 – 11/30/2020 | ≥85% |