Skip to content
 

BTE Participation for Physicians

Bridges to Excellence offers you the opportunity to evaluate and demonstrate the level of quality of care you deliver.  Participating in the program gives you tools to continuously improve your practice, all the while receiving national recognition and rewards. In addition, your patients will know that they are receiving care from a physician that has demonstrated he or she delivers a superior level of care.

Steps to Participation

Step 1: Determine if you are eligible. There are three criteria for BTE eligibility: service area, specialty, and if your patient panel includes employees of the participating employers and health plans.

a.  BTE service area – there are several regions that have implemented BTE, which means payers, purchasers and providers have come together to bring the BTE programs and rewards for provider certification to their area. Find out if BTE is in your area. Health plans are also increasingly using the BTE programs as part of their internal pay-for-performance programs.

b.  BTE programs and specialties – BTE offers several programs that provide incentives for improvement in care around practice systems, diabetes, cardiac care and other areas. To participate in the clinical programs, you must be able to provide the required amount of patient clinical data from your charts and be an eligible specialist.

c.  Patient counts and reward potential – Each eligible physician’s reward amount is based on the count of eligible employer patients treated by the physician. Eligible patients are determined by BTE Administrators (health plans) based on inpatient and ambulatory claims and encounter data for the members of participating employers. Eligible patient counts are revised up to twice each year based on new data supplied by health plans.  Find out if you are eligible for rewards.

Step 2Find out what certification means and what the performance measures are. Certification in BTE programs is a signal to the healthcare community of the superior care you as a physician and/or your physician practice delivers to patients on a day to day basis.

The Physician Office Link (POL) program certification represents your and/or your practice’s use of clinical information management systems to promote safe, effective, efficient and patient-centered care. Performance measures include the use of patient tracking and registry functions as well as patient management support.

Certification in BTE’s disease specific programs in diabetes, cardiac and spine care reflect a physician’s success in providing superior chronic care management to three sets of complex patient populations. The performance measures included in the Diabetes Care Link (DCL), Cardiac Care Link (CCL) and Spine Care Link (SCL) programs cover outcomes measures (such as blood pressure control and LDL control) and process measures (such as annual podiatry, ophthalmologic exams and use of imaging), which are important components of appropriate diabetic, cardiovascular and back pain patient care.

More information on BTE certification and the performance measures for BTE's programs

Step 3: Obtain certification. Choose which BTE program you want to participate in and to which performance assessment organization (PAO) you want to apply. BTE has partnerships with several performance assessment organizations – NCQA, ABIM and regional Quality Improvement Organizations (QIOs). If there is more than one PAO available to you, you have a choice. For example, in Massachusetts, NCQA and MassPro, Massachusetts' QIO, both are available to practices for Physician Office Link assessment.

The BTE certification measures are primarily focused on clinical data from the physician’s records and submitted to a third party assessment organization (for example, the NCQA) for scoring. To start the certification process, contact the Performance Assessment Organization for the appropriate application.  

Step 4: Receive rewards. Once you or your practice has obtained certification and you are eligible for rewards, a check from your health plan will arrive based on the market reward cycle. Generally, the rewards are paid on an annual basis for the term of the program as long as you maintain certification. You may be required by each health plan to complete and submit a W-9 form.

BTE Rewards

Each region or health plan has the flexibility to choose the reward level they feel will have the most positive impact in encouraging providers and practices to demonstrate that they deliver high quality care. BTE provides suggested reward amounts, but check with your region to find out the specific per patient amount.

Level of Recognition

Level I

Level II

Level III

Physician Office Link

$15

$30

$50

Diabetes Care Link
(POL regions / non-POL regions)

$80 / $100

$160 / $200

N/A

Cardiac Care Link
(POL regions / non-POL regions)

$80 / $100

$160 / $200

N/A

Spine Care Link

$0

$50

N/A

Another important component of participating in BTE is educating your patients on the importance of certification and encouraging them to seek all of their care from recognized physicians. Patients can get a list of recognized physicians at www.healthgrades.com

 

 

© BTE 2007. All rights reserved.
Bridges to Excellence does not endorse any particular product or service or any physician or physician group. Bridges to Excellence relies on third-party performance assessment organizations such as the NCQA and Quality Improvement Organizations to measure a physician or physician's group performance and ability to demonstrate that they meet certain measures of quality care.