Providers
- encourage providers to deliver optimal care
- recognize and reward providers who demonstrate that
they have implemented comprehensive solutions in the
management of patients, and that they deliver safe,
timely, effective, efficient, equitable, and patient-centered
care
Patients
- encourage patients to seek evidence-based care
- reward patients with chronic diseases who take an
active role in managing their own care and achieve
target goals aimed at improving their health
BTE's focus is defined in several key areas:
- BTE involves 3 key programs that target office practices,
diabetes care, and cardiac care
- program costs are paid by participating purchasers,
based on their count of member patients
- roll-out is occurring in selected market areas:
Cincinnati, Louisville, Massachusetts, and Albany/Schenectady,
NY
| Performance
incentive |
Population-based
up to $50 per patient per year for top performance |
Condition-specific
$100 per diabetic patient per year
|
Condition-specific
Up to $160 per cardiac patient per year |
| Frequency |
Yearly |
Yearly |
Yearly |
| Targeted
Provider |
All
physicians |
PCPs
and Endocrinologist |
PCPs
and Cardiologist |
| Patient
Engagement |
Provider
report card |
DiabetesCareRewards, Certified Diabetic Educators
|
CardiacCareRewards,
Certified Dieticians |
| *Expected
Costs & Savings |
Cost = up to $50 per patient per year (at most)
Gross Savings = $110 per patient per year
|
Cost = $150 per diabetic patient per year (at
most)
Gross Savings = $350 per diabetic patient per
year
|
Cost = up to $190
Gross Savings = up to $390
|
* Cost reflected is an estimate. Interested employers
should contact [email protected].
PDF presentation detailing the BTE
Business Case and program measures
PDF presentation of BTE
Program Overview
Roles and Responsibilities
Bridges to Excellence involves the collaborative effort
of many groups and individuals. Key participants to
the success of BTE are:
- BTE Executive Committee
- BTE Vendors
- Purchasers
- Health Plans
Purchasers
Purchasers participating in the BTE initiative have
some key responsibilities:·
- execute participation agreement: agree to participate
in the BTE project by signing the BTE Participation
Agreement
- engage health plans: engage all health plans with
which the purchaser contracts and which will be providing
physician and patient data for the BTE project
- execute data release agreements: work with health
plans and Medstat to execute any required data release
agreements to permit the health plan to transfer the
purchaser's physician and patient data to Medstat
- pay rewards and administrative fees: establish banking
arrangements with Medstat for the payment of physician
rewards, Medstat administrative fees, and other BTE-determined
project fees; ensure timely payment of all funds
- communicate with employees: distribute communications
to employees regarding BTE and participation in programs
with disease management tools and rewards
- outreach to region: participate in Regional Implementation
Team, working to improve region project performance,
including participation by physicians, employees,
and new purchasers
Employer BTE implementation
checklist
In addition to the BTE vendors,
BTE operates as a collaborative effort with Regional
teams, the BTE Executive Committee, the working group,
along with the interested health plans all striving
to achieve the goals of the Bridges to Excellence programs.
The Executive Committee of Bridges to Excellence sets
program policy and strategy, and approves new programs.
The Committee reviews overall performance measures from
each of the BTE programs, and evaluates results.
The Regional Implementation team's main objective is
to manage/improve the region's performance in recruiting
physicians and new employers to join Bridges to Excellence,
which drives the overall project results. The team is
composed of Purchaser representatives, operational representatives,
health plans, physicians and vendors.
The Working Group supports the regional implementation
of Bridges to Excellence and makes overall recommendations
on the design of each of the BTE the programs.
Health Plans
Health Plans participating in the BTE initiative have
the responsibility of executing any of the required
contracts and producing data files within the timeframe
of the regional implementation. Health Plans can also
play a key strategic role in recruiting physicians for
Bridges to Excellence participation.
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