to Excellence is a multi-state, multiple employer initiative
designed to reward quality across the healthcare system, created
to encourage significant leaps in the quality of care by recognizing
and rewarding health care providers who demonstrate that they
deliver safe, timely, effective, efficient and patient-centered
care. In addition to NBCH, Bridges to Excellence participants
include large employers, health plans, the National Committee
for Quality Assurance, MEDSTAT and WebMD Health, among others.
The organizations are united in their shared goal of improving
health care quality through measurement, reporting, rewards
organizations participate in Bridges to Excellence?
organizations include NCQA among its charter members and a
diverse coalition of physicians, health plans, quality experts
and consultants advance the pay-for-quality concept. Charter
employers include General Electric, UPS, Procter & Gamble
and Verizon, all of which offer bonus payments to physicians
who deliver high-quality care to their employees.
organizations administer the program and what are their
National Committee for Quality Assurance (NCQA) selects
which physicians qualify for awards based on evaluating and
verifying their data. NCQA is the leading independent organization
providing information that allows purchasers and consumers
of health care to distinguish among health plans and physicians
based on quality of care.
acts as overall program manager and is in charge of distributing
Pine and Associates in the Diabetes Care Link and
Cardiac Care Link programs, helps participating physicians
risk adjust their data to account for the relative health
of the patients they treat.
addition, Partners Community Healthcare, Inc., the
Lahey Clinic and the Cincinnati Childrens Hospital
Medical Center, all among the nations most highly
regarded medical institutions, played important roles in
shaping the initiative.
is eligible for Bridges to Excellence?
treat employees or covered family members of the participating
employers may receive bonus payments and recognition under
am interested in learning more about the metrics involved
in STEEEP. For example, how does Bridges to Excellence
define and measure "S- Safety, T- Timely, E- Effective"...etc.,
and how is this information reported?
The definition of STEEEP is included in the IOM's report,
Crossing the Quality Chasm, which we have referenced in
the literature/reference list. The report has a full description
of what each concept represents. We believe we're impacting
all of these through the combinations of our programs and
the measurement of provider performance against POL, DCL,
CCL and the patient experience of care. In fact, the programs
were designed using the STEEEP criteria as "CTQs". One example
would be the e-prescribing and e-ordering module in PPC
as helping to significantly decrease drug-related errors
and improving the safety of patient care. Another example
is the measurement of clinical outcomes for patients with
diabetes or cardiac disease as having a very significant
impact on the effectiveness of care. Finally, the patient
experience of care survey that we are collecting and reporting
impacts the patient-centeredness of care.
is the relationship between HealthGrades and Bridges to
supports the Bridges to Excellence Program by building and
maintaining the Physician Quality Ratings and Physician
Practice Portal Websites. This includes gathering and scoring
patient satisfaction data through Bridges to Excellence
surveys and allowing practices to self identify through
a single national portal.
Bridges to Excellence use any HealthGrades data?
No, data comes
from Bridges to Excellence's other partners such as Medstat
and The National Committee for Quality Assurance (NCQA).
HealthGrades builds, hosts, and maintains the Physician
Quality Ratings Website.
is Data Processing Engine & Repository (DPER)/BTE Recognition
Data Exchange (RDE)/BTE Operations (BTE Ops)?
Data Exchange facilitates coordinated automated market
wide BTE Operations for all stakeholders by:
different modes of operating the program in a market.
2. Providing appropriate level of coordination.
3. Allowing for the potential of multiple Performance
Assessment Organizations in a single market.
4. Connecting as a single entry point to the Physician
Portal in order to share the Practices composition information
5. Providing systematic platform to display provider quality
ratings to plan members/employees.
is Bridges to Excellence targeting diabetes?
to the American Diabetes Association, more than 17 million
Americans suffer from diabetes, ranking it among the nations
most serious health issues. Employees suffering from poorly
controlled diabetes typically miss about 12 days of work per
year due to the illness, as compared to just two days for
diabetics whose illness is well controlled.
do I find physicians participating in this program?
physicians achieving certification or recognition will be
promoted through the Diabetes CareRewards website. If you
find a physician from whom you wish to seek services, be sure
to check with your health plan to verify that the physician
is covered within your network.
do physicians need to do to qualify for bonus payments?
qualify for bonus payments, physicians will measure the percentage
of their diabetic patients whose blood pressure, blood sugar
and lipid levels are sufficiently measured and controlled.
The performance measures for Diabetes Care Link are based
on those used in the American Diabetes Association/NCQA
Diabetes Physician Recognition Program (DPRP).
performance results indicate that DPRP-recognized physicians
provide quality care and have improved care delivery between
1997 and 2001:
average rate of diabetes patients who had Hemoglobin
A1c (HbA1c) levels of less than 8 percent increased
from 50 percent to 70 percent, an indication that more
adults with diabetes are maintaining proper HbA1c control.
HbA1c is a measure of average blood sugar over the previous
rate of diabetes patients who had properly controlled
low-density lipoprotein (LDL) cholesterol gained 35
percentage points (37 percent to 72 percent).
rate of diabetes patients monitored for kidney disease
rose from 60 percent to 84 percent.
is Diabetes CareRewards?
CareRewards is an online program specifically designed for
patients diagnosed with diabetes. Industry research has shown
that people with diabetes are concerned about eating well,
minimizing stress, staying active, and finding resources to
manage their condition. Diabetes CareRewards provides online
personalized support and incentives to help you achieve an
optimal level of diabetes health. This new resource promotes
the achievement of target diabetes goals to improve your health
and prevent diabetes complications. By working to optimally
manage your diabetes, you'll be eligible to earn points via
sponsors the Diabetes CareRewards program?
powerful coalition of employers and health plans has joined
together to promote the achievement of target diabetes goals
to improve the quality of diabetes care and prevent diabetes
is the value of the bonus payments?
meeting the necessary thresholds will receive a yearly bonus
of $80 for each of their diabetic patients covered by one
of the participating employers. For example, a physician who
treats 150 diabetic employees or family members would receive
a $12,000 year-end bonus.
is the difference between a certified and a non-certified
certified physician has demonstrated good outcomes in the
management of patients with diabetes. Good outcomes in diabetes
care is achieved by successfully completing the requirements
for certification or recognition of the Diabetes Physician
Recognition Program (DPRP) administered by the National Committee
for Quality Assurance (NCQA) and sponsored by the American
Diabetes Association (ADA).
I have to change physicians to participate?
You do not have to change doctors to be eligible to use the
Diabetes CareRewards website or participate in the Diabetes
there any other facets to Diabetes Care Link?
Diabetes Care Link will also include a reward program to encourage
employees and family members to take a more active role in
managing their condition. In addition, patients with diabetes
will be eligible for tools, support and information. By using
these tools, they may receive incentives such as cash, discounted
co-payments or other rewards.
is Diabetes Care Link being piloted?
Care Link completed its pilot in Cincinnati, Ohio and Louisville,
KY on December 31, 2005. It is currently being piloted in
Massachusetts & Capital NY Region (Albany-Schenectady-Troy).
healthcare costs rising, how can Diabetes CareRewards be
offered to me?
a patient and physician work together for better health, costs
go down for everyone.
is Bridges to Excellence targeting cardiovascular care?
to the American Heart Association/American Stroke Association,
more than 60 million Americans have one or more types of cardiovascular
disease. It is the leading cause of death in the United States.
do physicians need to do to qualify for bonus payments,
Care Link is similar to Diabetes Care Link in that it will
ask physicians to measure their performance in key areas of
care. Physicians who meet the necessary thresholds will receive
financial incentives for each of their cardiovascular patients
covered by one of the participating employers. Final measures
for Cardiac Care Link were released in 2003; they are based
on those used in the Heart/Stroke Recognition Program (HSRP)
developed by the American Heart Association/American Stroke
Association and NCQA.
is Bridges to Excellence targeting office systems?
processes contribute to improvements in health care. Physicians
who use systematic processes are better able to:
their patients' medical histories
with patients over time, not just during office visits
up with patients and with other providers
populations, not just individuals, using evidence-based
better health habits and self-management of medical
standards are in Physician Office Link?
NCQA has developed
Physician Practice Connections (PPC), the performance assessment
for the Bridges to Excellence rewards program, Physician
Office Link. PPC assesses office practices' performance
in the areas of clinical information systems, patient education
and support and care management.
PPC standards means that practices have connections--to information,
to patients, to other practitioners, to evidence. The connections
in PPC take several forms, and NCQA evaluates three overlapping
categories of standards:
Information Systems/Evidence-Based Medicine:
How does the practice use information to keep track of patients'
treatments, follow up on tests, check medications and use
researched standards of care?
Patient Education and Support:
How does the practice use resources and referrals to help
patients manage their own health? How does the practice
measure and improve quality?
How does the practice actively help patients with chronic
conditions and patients with very complex problems maximize
their health and prevent hospitalization?
What do physician practices need to do to qualify for bonus
pass NCQA's Physician Practice Connections program, practices
must submit data in any one of the three performance areas
above. To qualify for full Physician Office Link rewards,
practices must submit data and obtain a three-year recognition
in each of the three performance areas.
episodes of care are included in the POL evaluation? Are
they the same episodes used in evaluating DCL and CCL? Or
does the average cost per episode include all episodes?
These are all episodes and so include anything from a cold
to a broken leg or a chronic condition. There are several
episodes per patient as opposed to the DCL/CCL analyses
which only include the chronic illness and have year-long
episodes. We are conducting a supplemental analysis that
will look at the differential impact on specialists as opposed
will be the timing of the 2006 rollout of the new POL 2.0
(For example if the Plan would like to time any announcement
of their proposed POL rollout accordingly to avoid any discrepancy
between the Plan's announced rewards and the rewards listed
on the BTE Web site)
POL reward structure
will NOT change in NY & MA BTE pilot regions through
end of pilot period 7/24/06.
or POST-pilot BTE markets, regional teams will provide the
markets with market-specific reward structures. If you are
in either of these markets, please contact your local BTE
administrator for rewards amounts.
are the Physician Office Link rewards determined?
a practice achieves a passing score on any one or all of the
Physician Practice Connections modules, it is eligible to
receive a reward for each Bridges to Excellence employee or
family member who receives care at the practice. The amounts
of the rewards vary depending on the modules passed.
do physicians stand to gain by participating in Bridges
doctors could see income gains of up to 10 percent. In addition,
participating physicians are highlighted in provider directories,
helping employees and their families identify those doctors
who are best suited for treating particular illnesses, or
who have exemplary office systems for tracking care.