Blue Cross Blue Shield of Michigan is a nonprofit corporation and independent licensee
of the Blue Cross and Blue Shield Association
Collaborative Quality Initiatives Fact Sheet
Value-Based Reimbursement 2025
Anesthesiology Performance and Improvement Reporting Exchange (ASPIRE)
The Value Partnerships program at Blue Cross Blue Shield of Michigan (BCBSM) develops and maintains
quality programs to align practitioner reimbursement with quality of care standards, improve health
outcomes and control health care costs. Practitioner reimbursement earned through these quality programs
is called value-based reimbursement (VBR). The VBR Fee Schedule sets fees at greater than 100% of the
Standard Fee Schedule. VBR opportunities are available to all practitioners who participate in the
Anesthesiology Performance and Improvement Reporting Exchange (ASPIRE)
regardless of PGIP
enrollment. The coordinating center leaders, jointly with BCBSM, set quality and performance metrics for
the VBR. Each Collaborative Quality Initiative, or CQI, uses unique measures and population-based
scoring to receive BCBSM VBR. The CQI VBR is applied in addition to any other VBR the specialist may
be eligible to receive. The CQI VBR applies only to reimbursement associated with commercial PPO
BCBSM members. This is an annual incentive program.
Population-Based Scoring Methodology
The CQI coordinating center (not the physician organization) determines which practitioners have met the
appropriate performance targets and notifies BCBSM. Each physician organization will notify practitioners
who will receive CQI VBR, just as the PO does for other forms of specialist VBR.
Participants can only receive VBR for one CQI, even if they are participating in more than one CQI, with the
following exceptions:
1) Practitioners that participate in one of the four population-health based CQIs - INHALE, MCT2D,
MIBAC, MIMIND – can receive the related VBR in addition to other CQI VBR
2) Practitioners can receive 102% VBR for tobacco cessation in addition to other CQI VBR. The
tobacco cessation VBR is limited to one reward per practitioner but can be earned in addition to
other CQI VBR.
CQI VBR is not additive if the practitioner is contributing data to multiple CQIs. If a practitioner is eligible for
rewards through multiple CQIs, the practitioner will be awarded the highest level of CQI VBR.
ASPIRE uses a hospital-affiliated scoring model to measure performance. ASPIRE practitioners are
grouped by participating hospital level (physicians are assigned to the hospital where they have performed
the most cases) then measured as a hospital collective average.
Blue Cross Blue Shield of Michigan is a nonprofit corporation and independent licensee
of the Blue Cross and Blue Shield Association
VBR reward opportunities
Participants are scored on CQI performance measures according to the methodologies developed by each
respective CQI and are eligible for CQI VBR of 102%, 103%,105%, or 107% of the standard fee schedule if
they meet performance targets in one or more of those initiatives.
ASPIRE practitioners are eligible for one of the following VBR combinations (102%, 103%, 105%, or 107%)
a. To be eligible for 103% VBR, participants must achieve target on 2 of 3 measures in the
measures listed in Table 1 below.
b. To be eligible for 105% VBR, participants must achieve target on 3 of 3 measures in the
measures listed in Table 1 below.
c. To be eligible for 102% VBR, participants must achieve target on 2 of 2 measures in the
tobacco cessation measures listed in Table 2 below.
d. To be eligible for 107% VBR, participants must achieve target on 3 of 3 measures (Table 1)
and 2 of 2 measures (Table 2).
VBR Measures
Table 1. VBR Measures Measurement Period
Target
Performance
Percentage of cases receiving general anesthesia that had at least
one core temperature documented intraoperatively. TEMP-02
10/01/2023 – 9/30/2024
≥80%
Percentage of cases where carbon dioxide equivalents normalized by
hour for cases receiving halogenated agents and/or nitrous oxide is
less than CO
2
eq. of 2% sevoflurane at 2L FGF = 2.83 kg CO
2
/hr
during the maintenance period of anesthesia OR the total CO
2
equivalents is less than 2.83 kg CO
2
. SUS-02
10/01/23 - 9/30/2024
≥40
%
Percentage of patients who had a procedure requiring general
anesthesia or cesarean delivery and received appropriate prophylaxis
for postoperative nausea and vomiting. PONV-05
10/01/23 - 9/30/2024
≥50%
Table 2. Tobacco Cessation VBR Measures Measurement Period
Target
Performance
Percentage of patients, ≥ 18 years of age, with tobacco status
documented within 30 days prior to any procedure requiring
anesthesia SMOK-01
10/01/23 - 9/30/2024
≥75%
(12-month
average)
Percentage of patients ≥ 18 years of age, who are documented as
current tobacco smokers and receive an approved tobacco cessation
intervention from an anesthesia provider. SMOK-02
10/01/23 - 9/30/2024
≥10%
(12-month
average)
VBR selection process
To be eligible for 2025 CQI VBR, the practitioner must:
● Meet the performance targets set by the coordinating center
● Have contributed data to the CQI’s clinical data registry for at least two years, including at least one
year’s worth of baseline data
Blue Cross Blue Shield of Michigan is a nonprofit corporation and independent licensee
of the Blue Cross and Blue Shield Association
Are practitioners participating in CQIs eligible for other specialist VBR?
Yes. Specialists are eligible to receive additional VBR if they meet the stated criteria. See the Specialist
VBR fact sheets for specialty-specific information.
About ASPIRE
● Builds collaborative relationships between surgeons and anesthesiologists
● Aims to reduce variation in intraoperative anesthesia practices, resulting in reduced postoperative
complications and costs, and better outcomes for patients. Collects data to measure, report, and
decrease unwarranted variation across several anesthetic domains of care, including:
o glycemic management
o hemodynamic management
o intraoperative ventilation
o neuromuscular blockade
o transfusion management
About the coordinating center
Michigan Medicine serves as ASPIRE’s coordinating center to collect and analyze comprehensive clinical
data from participating hospitals to identify specific care components associated with better patient
outcomes. It uses these analyses to examine practice patterns, generate new knowledge linking processes
of care to outcomes, and identify best practices and opportunities to improve quality and efficiency. The
center also supports participants in establishing quality improvement goals and in disseminating and
implementing best practices. Center leadership:
Program Director: Nirav Shah, MD
Administrative Program Manager: Tory (Victoria) Lacca
Clinical Program Manager: Kate Buehler, MS, RN
For more information on the CQI and measures, please contact Kate Buehler at
kjbucrek@med.umich.edu
.
About the CQI Program
Collaborative Quality Initiatives and Collaborative Process initiatives bring together Michigan physicians
and hospital partners to address common and costly areas of medical-surgical care, BCBSM and Blue
Care Network supports this effort and funds each collaborative data registry, that include data on patient
risk factors, processes, and outcomes of care. Collection, analysis, and dissemination of such data helps
inform participants on best practices. This, in turn, helps increase efficiencies, improve outcomes, and
enhance value. For more information, please contact Marc Cohen, Manager, Value Partnerships
mcohen@bcbsm.com.
About Value Partnerships
Value Partnerships is a collection of programs among physicians and hospitals across Michigan and Blue
Cross, that make health care better for everyone. This unique, collaborative model enables robust data
The information contained herein is the proprietary information of BCBSM. Any use or disclosure of such information without the prior consent of BCBSM is prohibited.
Blue Cross Blue Shield of Michigan is a nonprofit corporation and independent licensee
of the Blue Cross and Blue Shield Association
collection and sharing of best practices, so practitioners can improve patient outcomes. It is value and
outcomes-based health care -- a movement away from fee-for-service that instead pays practitioners for
successfully managing their patient’s health. We invite you to visit us at valuepartnerships.com.
The information contained herein is the proprietary information of BCBSM. Any use or disclosure of such information without the
prior written consent of BCBSM is prohibited.
