Health Plan Licensing

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 and the markets in which they are implementing BTE programs include:

Participating Health Plans

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. They do not have the right to implement BTE's programs for non-plan members. Non-plan members can participate in BTE's programs either through another health plan licensee (if available in that market) or through BTE directly.

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.

Does a health plan have to implement all BTE programs?

Health plans have the right, in collaboration with their customers and other BTE participants in the market, to select the programs they wish to implement. They are asked to actively cooperate with other BTE Licensees or Participants in any market to ensure that the Programs' impact will be as significant as possible.

Plan Licensees also have the right and flexibility to incorporate BTE's programs as part of their existing pay-for-performance programs, and to modify the recommended bonus amounts to reflect any rewards they have already built in their current pay-for-performance programs.

What are the obligations of Plan Licensees?

There are only a handful of obligations for plan licensees. These include:

  • Rewards paid by the Licensee have to be meaningful and positive, not simply punitive, and aimed at achieving a positive sum outcome for BTE program participants
  • Rewards should be paid after physicians have demonstrated high performance
  • Plan members should be encouraged to seek out recognized providers and plans should create incentives for better member self-care
  • Licensee should use independent national accrediting organization to assess and recognize provider performance community-wide
  • Licensee should continue pushing for ever-tougher standards on provider performance and demand complete accountability for use of resources and delivery of outcomes
  • Within the limits of applicable law, Licensee should participate in cross-learnings with other BTE participants and Licensees on the results of the program

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