Comparative Tables

Payer Policy Alignment Tables – Tools for Practices and POs

When payers align on common policies that promote high-quality primary care, administrative burden on practices is decreased and attention and time for patient care is increased.  The MMI participating payers (BCBSM, Priority Health, HAP and MDHHS) have worked to better align policies, metrics, and requirements.

As tools to aid in the important work of practices and physician organizations in Michigan, MMI and its participating payers have worked to create comparative tables for social care (SDoH) and telehealth approaches across payers.  There are many components for which policies have been aligned and others where we continue to work toward a common approach.  The tables are not a replacement for detailed billing guidelines and requirements but are intended as user-friendly tools for practice teams that provide high-level overviews.

NEW Collaborative Care Multipayer Policy Grid Released – To ease the path to understanding requirements and coding related to collaborative care, MMI has produced a new tool to make it easier for practices to partner PCPs with behavioral health professionals.  You will see that the MMI Participating Payers (BCBSM, Priority Health, HAP and MDHSS) have worked to align policies wherever possible to ease practice administrative burden.  All of the payers use the Washington AIMS Model as a basis for policies and requirements.   Collaborative Care (CoCare) implementation has expanded across the state in the last few years and the grid is intended to serve as a helpful tool for those who have already begun implementation and for those interested in learning more.

Telehealth – The telehealth policy table features highlights of payer policies for key areas like audio-only coverage and site of care.  The table will be updated quarterly.

Social Care (Social Determinants of Health) – The Social Care policy table focuses on the approaches that plans use to reward practices and POs for screening and health exchange use case participation.  The table will be updated annually with updates published in January.

We are working on developing tables for additional areas and will post them as they are completed.