BTE Medical Home: Bridges to Excellence

 

BTE Medical Home

 
A medical home provides patients with access to quality health care from doctors who practice evidence-based guidelines; use appropriate health information technology; and demonstrate the use of “best practices” while being accountable for the quality and value of care. The medical home approach was initially developed by the American Academy of Pediatrics and has been fully endorsed by the American Academy of Family Physicians, American College of Physicians and the American Osteopathic Association. Members of the Patient-Centered Primary Care Collaborative (PCPCC), a coalition of major employers, consumer groups, and other stakeholders including BTE, have joined with organizations representing physicians to develop and advance the patient-centered medical home.

Physicians who are able to attain a BTE Medical Home designation can receive an annual bonus payment of $125 for each patient covered by a participating employer, with a suggested maximum yearly incentive of $100,000.

Check out the Medical Home Analysis – Savings Estimate.

BTE Medical Home Designation:


To obtain the rewards available through the BTE Medical Home designation, eligible physicians must demonstrate that they have adopted really good systems and processes of care, and are using those systems to deliver positive results in the management of their patients – in particular patients with chronic conditions. BTE Medical Home designation is achieved through a combination of BTE’s existing programs.

  • Good systems and processes are identified through the achievement of Level II or III recognition in BTE Physician Office Link (POL) program, which requires a practice to demonstrate it is collecting and using information to improve the management of patient care and has electronic systems to promote patient safety.
  • Good outcomes are identified through the achievement of Level II or III in any two BTE condition-specific programs, which demonstrate that physicians are measuring and reporting clinical performance resulting in improved delivery of care. Currently, these programs include BTE’s Diabetes Care Link, Cardiac Care Link and Spine Care Link.

Physicians meeting both of these requirements will automatically be designated a BTE Medical Home.

BTE Levels of Recognition:


In order to promote continuous quality improvement, BTE has introduced tiers of recognition to its programs. The BTE program has been tiered to include three levels of recognition.

  • Level I: Based on “classic” measurement of individual metrics summed to produce a score. The thresholds are set to focus on above average performance (at about the 50th national percentile).
  • Level II: Focused on individual metrics, but all intermediate outcome measures are “must pass”. The thresholds are set to focus on really good performance (at about the 75th national percentile).
  • Level III: Requires physicians to demonstrate that they are using advanced processes and delivering all the right care to patients. Level III is based on patient-centered assessment, and the thresholds are set to focus on the very top performers (at about the 90th national percentile).

As described above, physicians achieving Level II or III in POL and a combination of two of the three condition-specific BTE programs at Levels II or III will automatically receive a BTE Medical Home designation.

Does obtaining recognition improve the quality of health care?


Yes. The BTE Medical Home designation is built around BTE’s provider recognition programs, for each of which quality improvement has previously been demonstrated; therefore, their combination will produce the same quality improvement results as the individual programs. Health information technology, promoted through Physician Office Link, is a key component in the improvement of quality and efficiency of care that is delivered; while the condition-specific programs each have their own quality improvement results. For example, NCQA’s Diabetes Provider Recognition Program (DPRP) historical results show that for DPRP applicants from 1997 to 2003:

  • The average rate of diabetes patients who had Hemoglobin A1c (HbA1c) levels of less than 7 percent increased from 25 percent to 46 percent, an indication that more adults with diabetes are maintaining proper HbA1c control. HbA1c is a measure of average blood sugar over the previous three months.
  • The rate of diabetes patients who had controlled low-density lipoprotein (LDL) cholesterol below 100 mg/dl rose from 17 percent to 45 percent.
  • The rate of diabetes patients monitored for kidney disease rose from 60 percent to 85 percent. Data source: NCQA

What is the duration of Recognition?

For BTE Medical Home recognitions achieved on or before December 31, 2009, recognition status remains in effect for 3 years from the date on which a PAO awards recognition.  Beginning January 1, 2010, the BTE Medical Home recognition duration will be shortened to 2 years from the date on which a PAO awards recogntion.

How will the public know which physicians have obtained recognition?


All BTE rewards-eligible practices and physicians who obtain the BTE Medical Home designation is promoted as recognized practices and physicians on the HealthGrades’ Physician Quality Ratings website. Consumers can use this directory to identify physicians in their area who demonstrate a high level of performance in providing care.

Additional information on the BTE Medical Home Designation:

For questions, please contact BTE.