Participation > Health Plans
Health Plan Participation
Health plans play a critical and important role in the administration of BTE. Health plans have always been a valued stakeholder since BTE started in 2003; but recently, BTE has moved from a "do it yourself" employer model to a model that is led by health plans who have taken the initiative to license BTE; adopting it along side, or as part of, what they do today. All national and many local plans have licensed BTE's programs and are implementing them in select markets for their fully insured or self-insured customers.
BTE Licensing details
BTE Licensing agreement: the standard agreement is available for review. For detailed questions, contact BTE.
What does Licensing BTE Programs mean for a Health Plan?
Licensed health plans are given the non-exclusive right to implement BTE’s programs for their plan members on behalf of their self-insured customers or for their own fully-insured book of business. Moreover, BTE licensees are authorized to use the BTE brand and associated registered trademarks in promoting and implementing the programs locally.
Benefits of Licensing:
- Rewarding physicians for the right clinical behaviors, while driving care process changes that promote the delivery of high quality healthcare service.
- Providing your customers a suite of products that promotes better healthcare outcomes at a lower cost.
- Offering the consumer access to information to take a more active role in the healthcare decision-making process.
- Relying on a national program that has been successfully implemented in markets across the country.
- But most of all, it means becoming a partner in the transformation process by which healthcare is purchased, delivered and consumed in the U.S. in the 21st century.
Health plans are required to execute a licensing agreement (link to agreement) and pay a modest licensing fee:
- Multi-State Plan: $150,000
- Single State Plan: $50,000
- Regional Plan: $25,000
What are the obligations of Health Plan Licensees?
- Rewards paid by the licensee have to be meaningful and positive, not simply punitive, and aimed at achieving a positive sum outcome for BTE program participants.
- Rewards should be paid after physicians have demonstrated high performance.
- Plan members should be encouraged to seek out recognized providers and plans should create incentives for better member self-care.
- The licensee should use independent accrediting organizations to assess and recognize provider performance community-wide.
- The licensee should continue pushing for ever-tougher standards on provider performance and demand complete accountability for use of resources and delivery of outcomes.
- Within the limits of applicable law, the licensee should participate in cross-learnings with other BTE participants and licensees on the results of the program.
BTE health plan licensees play an important role as the BTE program administrator for their clients, delivering on set of administrator roles and responsibilities vital to the success of BTE program implementations.
BTE Licensee Administrator Checklist