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PERFORMANCE ASSESSMENT

BTE Recognition is based on clinical data, which clinicians and practices voluntarily submit to an independent performance assessment organization (PAOs) for scoring. PAOs are one of the two types of organizations who take part in the performance assessment for BTE Recognitions. PAOs score the data, while Data Aggregators (BTE Approved Registries) collect the data from clinicians for scoring.

PAOs

PAOs have two critical roles in their BTE efforts:

  1. Performance Evaluator: PAOs are third-party organizations responsible for evaluating the performance of clinicians and practices nationally and recognizing those who demonstrate they provide high quality care in their communities. PAOs validate and score the data submitted based on BTE's clinical measures and specifications.
  2. Data Conduit: After recognizing eligible clinicians, PAOs act as the data conduit, submitting recognition data to BTE's data platform, the Recognition Data Exchange (RDE). The RDE distributes individual clinicians' recognition information to BTE administrators and consumer portals for use in their internal quality programs and public recognition. Consistent with BTE's principles, all assessment programs are voluntary and anonymous for clinicians – only successful recognitions are reported to BTE by the PAOs.

BTE has partnerships with leading PAOs, including NCQA, the Minnesota Community Measurement (MNCM) collaborative, and IPRO (New York's Quality Improvement Organization).

National Committee for Quality Assurance (NCQA) is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations, recognizes physicians, physician groups and other health care providers in key clinical areas and manages the evolution of HEDIS®, the tool the nation's health plans use to measure and report on their performance. NCQA is committed to providing health care quality information through the Web, media and data licensing agreements in order to help consumers, employers and others make more informed health choices.  Through its performance assessment programs, NCQA currently helps BTE select which clinicians qualify for recognition for four of BTE's programs:

 

MN Community Measurement (MNCM) was formed in 2002 by several local health plans as a collaborative to collect performance data. By aggregating health plan claims data and collecting clinical information from physician offices, MNCM publicly reports physicians' performance results in Minnesota. MNCM's goals include improving care and supporting the quality initiatives of providers, reducing reporting-related expenses for medical groups, health plans, and regulators through more efficient and effective regulation, and communicating findings in a fair, usable and reliable way to medical groups, regulators, purchasers and consumers.

IPRO is one of the nation's largest and most experienced not-for-profit quality assessment and improvement organizations.  IPRO's mission is to improve the quality and value of health care services, and does so by supporting the development and implementation of performance measures; increasing the capacity of providers and government agencies for performance improvement; and fostering an environment, through transparency and payment reform efforts, that rewards high-quality, high-value care.  With 400 staff, IPRO performs work in over 30 states, serving federal, state and local government, and private clients.

MNCM and IPRO both currently offer assessment options for the following BTE Recognition programs:

  • Asthma Care Recognition
  • Cardiac Care Recognition
  • Chronic Obstructive Pulmonary Disease (COPD) Care Recognition
  • Congestive Heart Failure (CHF) Care Recognition
  • Coronary Artery Disease (CAD) Care Recognition
  • Diabetes Care Recognition
  • Hypertension Care Recognition
  • Physician Office Systems Recognition

BTE has also recently collaborated with the American Board of Internal Medicine (ABIM) to allow the ABIM PIMS Practice Improvement Modules for Diabetes to be used for clinicians to achieve recognition and rewards through BTE. BTE has recognized the ABIM Diabetes PIM as effective tools for quality improvement and seeks to reward physicians who achieve certain levels of performance on it by examining clinician PIM Diabetes data to determine if the standards for Recognition are met. ABIM and BTE are aiming to launch a similar program for the ABIM PIM in Hypertension.

Through these PAOs, BTE offers multiple pathways for clinicians to apply for and achieve BTE Recognition.  Eligible clinicians can extract medical record data and submit directly to a PAO (either NCQA or IPRO) or sign-up with a participating EMR or patient registry vendor to have their data submitted to a PAO (either MNCM or IPRO) on their behalf through BTE's automated EMR/Registry System.

BTE's Automated EMR/Registry System

In order to speed up, simplify and standardize a national clinician performance assessment process, BTE has created a performance assessment system for clinicians using electronic medical record data. The automated EMR/Registry System allows for rapid and independent, medical record-based clinician performance assessments by connecting local and national medical record data sources, or data aggregators (DAs) to BTE PAOs. Through the automated EMR/Registry System, BTE aims to: reduce the reporting burden for clinicians; leverage existing reporting/data aggregation initiatives; reduce data collection and reporting costs; facilitate the connection between quality improvement and incentives; and speed up cycle times between reporting and improvement.

Additionally, clinicians who achieve recognition in one of BTE's disease-specific Care Recognition Programs by submitting electronic data through a CCHIT or Meaningful Use certified EMR for performance assessment will also receive a Level II Physician Office Systems Recognition.

BTE is partnering with several electronic DAs across the country to leverage existing reporting initiatives. These DAs include EMR vendors, patient registries, decision support tool vendors, and health information exchanges. DAs act as the interface between their clinician customers and BTE's designated PAOs by ensuring the accuracy of data intake, extracting and sending the data to the PAOs for performance measurement, and reporting assessment results and quality improvement opportunities back to the clinicians.

With our automated system, clinicians must have electronic medical record data stored in a DA's system. We currently work with vendors such as:

  • GE (MQIC)  
  • NextGen
  • Allscripts
  • athenahealth
  • CINA
  • Meridios
  • Wellcentive
  • eClinicalWorks

Other vendors interested in becoming a BTE-approved EMR/Registry should review the requirements and development and approval process here.