The Pulse

A bi-weekly newsletter from your physician organization to

keep you informed of today's healthcare news

Friday, Sept. 18, 2026

The Physician Alliance specialists earn top reimbursement rating

Congratulations to our specialty physician members receiving a value-based reimbursement (VBR) from Blue Cross Blue Shield of Michigan! We are pleased to share that 96% of specialists are receiving a 12% VBR uplift, the highest uplift available.


And 99% of all specialists are receiving either 6% or 12% uplift at the provider level. This is amazing news - the outcome of tremendous hard work from physicians and their practice staff!


Value-based reimbursement levels are the result of specialist scores on cost and quality. Specialists are scored at the provider level and VBR is also based on overall scores of the provider's participating physician organization, such as The Physician Alliance.


TPA has some of the highest quality scores, helping to increase members' reimbursement rates. This is an important benefit for providers to consider when thinking of their physician organization because it impacts the ability to earn and maintain VBR.


Congratulations again to these specialty physicians! We are honored to work alongside you to improve the health of our communities!

TPA practices earn 5-star rating in patient experience

Patient satisfaction is an important part of the healthcare experience. A satisfied patient often is more compliant in completing health screenings and referring the practice to others, according to surveys conducted by insurance payers.


Blue Cross and Medicare are asking providers to remind Medicare patients that they will receive a patient satisfaction to better understand their healthcare experience. The survey collects patient‑reported feedback about their experiences with care, including access, doctor and staff communication, coordination, and customer service. The results are based on the patient's perspective, not on clinical documentation, and influence future Medicare Star Ratings.


The Physician Alliance currently has 5-star ratings in getting care quickly, care coordination, health care quality and getting needed care categories in Medicare Advantage PPO! These results highlight the hard work and dedication to patient engagement, care coordination and quality. Congratulations to our practices for providing excellent patient care!

Blue Cross rolls out new diabetes management program

Blue Cross Blue Shield of Michigan launched a new Chronic Condition Management Program for Diabetes in June to provide eligible Medicare members with Type 1 or Type 2 diabetes personalized and coordinated support.


Patient eligibility

The program targets Medicare PPO and Blue Care Network Advantage patients with HbA1c values of 9 or greater and who are not in full-risk arrangements. Members are identified using claims and lab data.


Program design

Participating patients receive 1:1 support from a dedicated care team that includes registered nurses and health coaches who are certified diabetes educators. Through telephonic assessment and collaborative care plan development, the team provides condition-specific education and lifestyle coaching to decrease A1c, decrease care gaps and improve medication adherence. The Blue Cross Chronic Condition Management team will coordinate care with the members’ primary care providers, specialists and other resources when appropriate.


Teladoc diabetes management program ends

As the new program gets underway, the Teladoc Diabetes Management Program will end for Medicare patients on August 31, 2026. After that date, Teladoc diabetes coaching, remote monitoring and account access will end. Patients can continue to use a Teladoc glucose monitor as long as they have Teladoc test strips, but they should talk with their primary care providers about switching to diabetes monitoring supplies that best fit their ongoing care needs and that are covered by their benefit plans.


A key enhancement of the Blue Cross program is the inclusion of eligible patients who use continuous glucose monitors. Expanding program eligibility to members who use a broader range of diabetes monitoring devices allows more members to receive condition-specific education and support that complement their provider-directed treatment plans. When continuous glucose monitoring is deemed clinically appropriate by the patient’s provider, Blue Cross aims to ensure these members also have access to coordinated diabetes management support.


Transition plans

Blue Cross reached out to all current Teladoc-engaged patients from June through August 2026 to inform them of this change. Those also eligible for the new Blue Cross program will be encouraged to participate.


Contact

If you’re working with a Medicare Advantage patient who has diabetes, an HbA1c of 9 or higher and could benefit from additional diabetes support, please contact Blue Cross at 800-775-2583.

Are you getting paid what you expect (& deserve)?

Provider compensation continues to rise across many specialties - even as productivity, patient encounters, and work RVUs may be stagnant or declining. What do these trends mean for physicians and private practices? How do you know when it may be time to review, recalibrate, or renegotiate compensation?


Join The Physician Alliance for live, members-only webinar and get a special glimpse inside provider compensation trends and how it may impact you.


October 20, 2026

12-12:30pm

Register Today.


This webinar will provide a focused look at the latest provider compensation and productivity trends nationally and across the Midwest, and what the data may mean for physician compensation, employment agreements, and professional services agreements (PSAs).


Attendees will better understand the data behind compensation decisions and learn to recognize opportunities to review their compensation strategy and agreements.


Learning Objectives:

  • Recognize key 2026 compensation and productivity trends nationally and across the Midwest
  • Understand the relationship between compensation, productivity, and wRVUs and why changes in one measure may not translate directly into another.
  • Identify compensation beyond clinical productivity, including call coverage, medical directorships and other responsibilities that may warrant separate consideration and FTE evaluation.
  • Recognize when it may be time to review compensation arrangements based on changing benchmarks, responsibilities, productivity methodology or practice circumstances.


Speaker:

Jessica Minesinger, CMOM, CMPE, FACMPE, BBCC, Medical Group Management Association Consultant

Stay updated on the latest healthcare news

Medicare to cover colorectal cancer screenings ordered by PAs, APRNs, Becker's Clinical Leadership

Scientists sound alarm over GLP-1 meds’ serious health consequences, Newsweek

As diseases loom, CDC's response to measles deaths stirs fears about agency's reliability, NPR

CDC issues alert about nationwide increase in rabies exposures, CNN

Scientists Find Possible Key To Blocking Breast Cancer Before Tumor Forms, Newsweek

The Meltdown in Employer-Sponsored Health Insurance, Kaiser Health News

‘The payers are winning’: Revenue cycle leaders’ big threats for the future, Becker's Hospital Review

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