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BTE Rewards

Which physicians are eligible for rewards?

The three Bridges to Excellence (BTE) reward programs (POL, DCL, and CCL) are targeted at doctors (MD's and DO's) who are primary care physicians, endocrinologists, cardiologists, and neurologists. These physicians and their office practices are eligible to receive the rewards offered under the BTE programs if they:

  1. provide care for eligible patients identified by Bridges to Excellence based on data supplied by the participating health plans for the participating purchasers
  2. demonstrate high levels of performance in BTE program content areas by obtaining passing scores on NCQA's physician performance measures for the BTE program
Physicians who are eligible to receive the rewards offered through Bridges to Excellence will be contacted by BTE and notified of their eligibility. Bridges to Excellence is currently active in the following market areas: Cincinnati (DCL), Louisville (DCL), Massachusetts (POL, DCL, CCL), and Albany/Schenectady (POL, DCL, CCL).

If I'm eligible, how can I receive the rewards?

Primary Care Physicians
Eligible primary care physicians (PCPs) can obtain the rewards offered under the POL program if their office practice passes NCQA's office practice performance assessment program. After obtaining POL rewards, PCPs also may be eligible to receive rewards offered under the DCL and CCL programs, if they have eligible diabetes and/or cardiac patients. To obtain the rewards offered under the DCL program, PCPs must pass NCQA's diabetes care performance assessment program. To obtain the rewards offered under the CCL program, PCPs must pass NCQA's cardiac care performance assessment program.

Endocrinologists
Eligible endocrinologists can obtain the rewards offered under the DCL program if they pass NCQA's diabetes care performance assessment program. Endocrinologists also can receive the rewards offered under the POL program by passing NCQA's office practice performance assessment program.

Cardiologists/Neurologists
Eligible cardiologists and neurologists can obtain the rewards offered under the CCL program if they pass NCQA's cardiac care performance assessment program. Cardiologists and neurologists also can receive the rewards offered under the POL program by passing NCQA's office practice performance assessment program.

As a PCP, endocrinologist, cardiologist, or neurologist, you can simply follow the steps outlined in the BTE Eligibility-Reward Diagram to receive your eligible rewards.

How is my eligible patient count determined?

Each eligible physician's reward amount is based on the count of eligible purchaser patients treated by the physician. Eligible patients are determined by Bridges to Excellence based on inpatient and ambulatory claim and encounter data supplied by the participating health plans for the participating purchasers. Eligible patient counts are revised up to twice each year based on new data supplied by health plans.

  • POL: counts are based on patients seen for office visits
  • DCL: counts are based on patients with a diagnosis of diabetes
  • CCL: counts are based on patients with a diagnosis of cardiovascular disease or who have had a stroke

How much reward can I earn?

Eligible physicians who pass NCQA's performance assessment criteria for office practices, diabetes care, and cardiac care can receive the following annual reward amount for each eligible patient identified by BTE, up to $130 per patient:

  • POL: up to $50 annually for each eligible patient treated in the physician's office
  • DCL: $80 annually for each eligible diabetes patient treated
  • CCL: up to $160 annually for each eligible cardiac patient treated

The maximum per-physician reward amount available through Bridges to Excellence is $20,000 annually or $50,000 over the life of the BTE program.

I have rewards available-what do I do next?

If you have been notified by Bridges to Excellence that you may be eligible to receive rewards for one of the BTE reward programs, simply follow the 1-page instructions below to obtain your reward:

For Cincinnati/Louisville Physicians

The Cincinnati and Louisville market areas currently have implemented only the Diabetes Care Link (DCL) program. Eligible physicians who pass NCQA's diabetes care performance assessment program can receive $100 per eligible diabetes patient.