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Helping patients take an active role in managing their health is an important part of improving outcomes, especially for patients with chronic conditions or those who need additional support managing their care.

To help practices engage these patients, The Physician Alliance (TPA) has launched a new Care Management Toolkit, featuring resources to support participation in Collaborative Care Management (CoCM) and Provider-Delivered Care Management (PDCM) services.

CoCM and PDCM provide practices with effective ways to engage eligible patients in their care, connect them with additional support and help them better manage chronic conditions. They can also help practices address care needs and improve performance on important quality measures.

What's Included?

The Care Management Toolkit provides ready-to-use materials to help practices promote and support care management, including:

• Patient education materials to explain care management and its benefits
• Staff overview materials to help practice teams understand and promote CoCM and PDCM
• Social media graphics to raise awareness and encourage patient participation (like current image)
• Letter and text templates for patient outreach
• Coding resources to support appropriate billing and documentation

These resources can make it easier for practices to communicate the value of care management, reach eligible patients and encourage them to participate.

Engaging patients in their own care can lead to better care experiences, stronger chronic condition management and improved quality performance. The new Care Management Toolkit joins other quality toolkits to give TPA members practical resources to help make those connections.

The toolkit is available now through the secure TPA member portal. Log in to explore the new Care Management Toolkit and find resources your practice can use to support patient engagement and quality improvement.

Despite many in the Michigan healthcare community expressing strong concerns about policy changes, Blue Cross Blue Shield of Michigan (BCBSM) began roll out of their revised incident-to billing policy on Sept. 1, 2026.

Incident-to is a billing practice that allows services performed by a provider to be billed under a supervising physician’s or non-physician’s National Provider Identifier (NPI) and reimbursed at the supervising provider’s rate. This may occur when the rendering provider has a lower level of licensure than their supervising provider, or when the rendering provider isn’t directly enrolled with Blue Cross or BCN.

For dates of service starting on Sept 1, 2026, eligible providers who deliver services to Blue Cross or BCN commercial members incident-to another provider should file claims under their own NPI. Providers who continue to bill incident-to will be required to use a designated modifier (SA) on the claim. These claims won’t be eligible for value-based reimbursement, or VBR. Beginning March 1, 2027, eligible providers will be required to file claims under their own NPI.

What to know and do:

For dates of service starting on Sept. 1, 2026, through Feb. 28, 2027:

• Claims submitted incident-to a physician or non-physician must use the incident-to modifier (SA) and will be reimbursed at the submitting provider’s applicable payment rate.
• Additional value-based reimbursement won’t be applied to incident-to claims, including claims associated with providers participating in the Physician Group Incentive Program, or PGIP.
• Only claims submitted directly for services performed by a PGIP participating physician or PGIP non-physician will be eligible for VBR.

For dates of service starting on March 1, 2027:

• Physicians and non-physicians eligible for direct participation with Blue Cross or BCN must submit claims directly.
• Providers who are eligible to bill directly but continue to bill incident-to with the SA modifier will receive 80% reimbursement and won’t be eligible for VBR.
• Only claims submitted directly for services performed by PGIP participating physicians or non-physicians will be eligible for VBR.
• Providers considered by Blue Cross to be in training, such as students and providers with provisional licensure, will no longer be eligible for reimbursement for incident-to billing in a professional setting.

Note: These changes won’t apply to providers affiliated with Medicare Plus Blue℠ and BCN Advantage.

Eligible providers will have six months, starting on Sept. 1, to enroll with Blue Cross or BCN before they’re required to start billing directly on March 1.

The Physician Alliance will share updates on this billing policy change as we receive information.

Every strain in this year’s flu vaccine differs from what practices stocked last fall. The FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) met in March and recommended updates to all three vaccine components, the first full reset in several years.

For practices finalizing fall orders, that shift is worth considering now, both for what changed and why.

What This Means for Fall Ordering

For practices, this translates to several practical steps rather than a single change. The vaccine remains trivalent, meaning it targets three flu strains, rather than quadrivalent, which targets four. That’s been the case since the 2024–25 season. Nothing changes about the number of components in this year’s vaccine, only the viruses those components target.

Practices should confirm directly with each manufacturer that fall shipments reflect the updated formulation, rather than assume an order will simply carry over from last season. This is particularly important for practices using more than one brand or production type, since egg-based, cell-based, and recombinant vaccines may not complete reformulation and release on the same timeline.

That timeline is also a reason to order early. Manufacturers need time to reformulate, produce, and release each updated vaccine, and any slowdown along the way is more likely to result in a delayed shipment than a canceled order. Placing orders early and asking about anticipated shipping windows gives practices more flexibility if a particular product falls behind schedule.

Ordering season is also a convenient time to look beyond flu. Many patients who come in for a flu vaccine may also be due for an updated COVID-19 vaccine or, if eligible, an RSV vaccine. A single visit is often the easiest opportunity to provide all recommended vaccines.

Timing Still Matters Most

The CDC recommends flu vaccination for everyone age six months and older, ideally by the end of October. However, vaccination later in the season can still provide meaningful protection, as flu activity typically continues into the spring. Being prepared for that window depends on having vaccine available, placing the ordering timeline on equal footing with the clinical timeline.

Read the full blog post.

Contributed by Atlantic Health Partners, one of TPA's Affiliate Partners. AHP provides TPA members with free program enrollment, discounted pricing on top vaccines, eligible for rebates on purchases made through AHP.

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