BTE was developed by employers, physicians, health care services researchers and other industry experts with a simple mission: to create significant leaps in the quality of care by recognizing and rewarding health care providers who demonstrate that they have implemented comprehensive solutions in the management of patients and deliver safe, timely, effective, efficient, equitable and patient-centered care.
This mission is accomplished by paying bonuses to physicians that meet standardized expert-based performance measures developed or co-developed by the National Committee for Quality Assurance (NCQA), the Physicians Consortium for Performance Measurement, Medical Boards and panels of experts. BTE also includes an optional patient component that provides support tools and an incentive model for patients in order to align patient behavior changes with physician standards of care.
BTE is continuing to expand to include new purchasers and new markets. New purchasers who are interested in participating in Bridges to Excellence can either join current purchasers who already are participating in BTE in an existing market, or identify other purchasers in a new market area who also are interested in participating in Bridges to Excellence.
Atlanta Gas Light
Cingular Wireless LLC
City of Cincinnati
City of Colorado Springs
City of Fort Smith
City of Hannibal
City of Hot Springs
City of Quincy
Cincinnati Children's Hospital Medical Center
School District #11
Colorado Springs Utilities
Continental Cement Company
El Paso County
McNay Truck Line
Memorial Health System
MoDot & Mo State
North Carolina State
Penrose- St. Francis health Services
Quincy Public Schools
P&G Price Chopper
Ritz Carlton- Lake Oconee
State of Georgia
State of MN Employees
Health Plan Participation
In 2004 BTE entered into its first licensing agreement with a health plan, United Health Group. Since then, many other national and local plans have expressed an interest in licensing BTE's programs and implementing them in select markets, either for their fully-insured customers or their self-insured customers. Today, BTE Licensees include:
Blue Cross Blue Shield of North Carolina
CareFirst Blue Cross Blue Shield
Kaiser of Georgia
MVP Health Care
What does Licensing BTE Programs mean for a health plan?
In licensing BTE programs, health plans have the non-exclusive right to implement BTE's programs for their plan members on behalf of their self-insured customers or for their own fully-insured book of business.
The licensing agreement also authorizes the plan to use the BTE brand and associated registered trademarks in promoting and implementing the programs locally. In exchange for these rights a health plan is required to execute a Licensing Agreement and pay a modest licensing fee.
Employers can now implement BTE through their health plans by encouraging them to license the right to implement. To that end, BTE has crafted a contract addendum that employers can use when negotiating with their plan administers for services.
in a New Market
The goal of Bridges to Excellence is to influence physicians and medical practices to change their behavior regarding the care of patients. To achieve this change, the incentives or rewards available to physicians must be of sufficient size. The amount of physician rewards is tied to the number of participating purchasers' covered lives who are seen by physicians-the higher the number of purchasers' covered lives in a geographic area, the higher the potential reward available to the physicians who treat these purchasers' members. As a result, the combined number of covered lives of purchasers' in a market area must represent a sufficient segment of the local population to ensure the BTE reward program is effective.
In general, BTE participating purchasers' combined count of covered lives in a specific geographic market area should be:
- at least 50,000 and/or
- 8-10% of the local population.
If you are a purchaser who is interested in launching BTE in a new market area, determine your organization's number of covered lives (covered employees, dependents, and retirees) in the specific geographic area. If your organization alone has a sufficient number of covered lives to impact physicians in the market, you may be able to participate in BTE as an individual purchaser. More commonly, if your organization alone does not have enough covered lives to ensure significant physician impact in a market area, then you can participate in BTE by identifying other local purchasers who are interested in BTE, such that a significant number of covered lives is represented when combined across all interested purchasers.
When you have identified a sufficiently large number of covered lives in a new geographic market area, either as a single purchaser or combined with other interested purchasers, please contact Bridges to Excellence at 203-731-4465, or [email protected].