Bridges to Excellence offers you the opportunity to evaluate and demonstrate the level of quality of care you deliver. Participating in the program gives you tools to continuously improve your practice, all the while receiving national recognition and positive incentives. Positive incentives may take different forms including bonuses, fee schedule increases and preferred network tiering. In addition, your patients will know that they are receiving care from a physician that has demonstrated he or she delivers a superior level of care.

Steps to Participation

Step 1: Determine if you are eligible. There are three criteria for BTE eligibility: specialty, service area, and if your patient panel includes members of BTE participating employers and health plans.

a. BTE programs and specialties – The main eligibility criteria to apply for BTE recognition is specialty. BTE offers several programs that provide incentives for improvement in care around practice systems, diabetes, cardiac care and other areas. To participate in the clinical programs, you must be able to provide the required amount of patient clinical data from your charts and be an eligible specialist. All physicians who meet these criteria may apply for national BTE recognition.

b. BTE service area – Additionally there are several regions where BTE recognition is tied to positive incentives. Positive incentives can take several forms, including increased community recognition, highlighted entries in plan directories and websites, educational programs that urge members to seek care from recognized physicians and financial benefits like increased fee schedules. Health plans are increasingly using the BTE programs as part of their internal pay-for-performance programs. Find out if BTE is in your area. For additional information, contact your contracting health plans to see if they offer positive incentives for BTE recognition.

c. Patient counts and reward potential – Some physicians who demonstrate excellent performance may also earn a fixed annual bonus payment for each qualifying patient covered by a health plan or employer that participates in BTE. These incentives are funded from the savings achieved through lower health care costs, and the increased employee productivity that results from higher quality of care. Each eligible physician’s reward amount is based on the count of eligible employer or health plan patients treated by the physician. Eligible patients are determined by BTE Administrators (health plans) based on inpatient and ambulatory claims and encounter data for the members of participating employers and fully-insured health plans. Eligible patient counts are revised up to twice each year based on new data supplied by health plans. Find out if you are eligible for bonus rewards.

Step 2: Find out what recognition means and familiarize yourself with the performance measures. Recognition in BTE programs is a signal to the healthcare community of the superior care you as a physician and/or your physician practice delivers to patients on a day to day basis.

The Physician Office Link (POL) program recognition represents your and/or your practice’s use of clinical information management systems to promote safe, effective, efficient and patient-centered care. Performance measures include the use of patient tracking and registry functions as well as patient management support.

Recognition in BTE’s disease specific programs or Care Links (which include diabetes, cardiac, hypertension, coronary artery disease, congestive heart failure, asthma, COPD and spine care) reflects a physician’s success in providing superior chronic care management to sets of complex patient populations. The performance measures included in these programs cover outcomes measures (such as blood pressure control and LDL control) and process measures (such as annual podiatry exams, ophthalmologic exams and use of imaging), which are important components of appropriate patient care for BTE Care Link conditions.

More information on BTE recognition and the performance measures for BTE's Care Link programs 

Step 3: Obtain recognition. Choose which BTE program you want to participate in and through which pathway you want to apply. BTE has partnerships with several performance assessment organizations including NCQA, IPRO, and MN Community Measurement. If there is more than one pathway available to you, you have a choice. For example, physicians interested in Diabetes Care Link may apply through the NCQA’s DPRP, through IPRO’s direct data submission portal or through BTE’s Automated Performance Assessment System. All three of these pathways will lead to BTE Diabetes Care Link recognition.

The BTE recognition measures are primarily focused on clinical data from the physician’s records and submitted to a third party assessment organization (for example, the NCQA) for scoring. If you are submitting extracted data directly to the PAO, contact the Performance Assessment Organization for the appropriate application to start the recognition process. If you have electronic medical record data, you may have additional options through BTE’s automated Performance Assessment System. Interested physicians can email BTE to determine whether their electronic medical record system vendor is currently partnering with BTE for automated data submissions to a performance assessment organization.

Step 4: Receive rewards. Bonuses are one means by which physician are being rewarded for their recognition. Once you or your practice has obtained recognition and you are eligible for bonus rewards, a check from your health plan will arrive based on the market reward cycle. Generally, the rewards are paid on an annual basis for the term of the program as long as you maintain recognition. You may be required by each health plan to complete and submit a W-9 form. Other mechanisms for physician rewards include preferred network tiering and fee schedule increases.

BTE Rewards

Each region or health plan has the flexibility to choose the reward level they feel will have the most positive impact in encouraging providers and practices to demonstrate that they deliver high quality care. BTE provides suggested reward amounts, but check with your region to find out the specific per patient amount.