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.
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