Participation
Overview
BTE's mission is
to improve the quality of care through rewards and incentives
that focus on both health care providers and patients:
Providers
- Encourage providers
to deliver optimal care
- Recognize and
reward providers who demonstrate that they have implemented
comprehensive solutions in the management of patients, and
that they deliver safe, timely, effective, efficient, equitable,
and patient-centered care
Patients
- Encourage patients
to seek evidence-based care
- Reward patients
with chronic diseases who take an active role in managing
their own care and achieve target goals aimed at improving
their health
BTE's
focus is defined in several key areas:
- BTE involves
3 key programs that target office practices, diabetes care,
and cardiac care
- Program costs
are paid by participating purchasers, based on their count
of member patients
- Roll-out is
occurring in selected market areas, to find out if BTE is
available in your area, click
here to find your state.
| Performance
incentive |
Population-based
up to $50 per patient per year for top performance |
Condition-specific
$80 per diabetic patient per year
|
Condition-specific
Up to $160 per cardiac patient per year |
| Frequency |
Yearly |
Yearly |
Yearly |
| Targeted
Provider |
All
physicians |
PCPs
and Endocrinologist |
PCPs
and Cardiologist |
| Patient
Engagement |
Provider
report card |
DiabetesCareRewards,
Certified Diabetic Educators |
CardiacCareRewards,
Certified Dieticians |
| *Expected
Costs & Savings |
Cost
= up to $50 per patient per year (at most)
Gross
Savings = $110 per patient per year |
Cost
= $150 per diabetic patient per year (at most)
Gross
Savings = $350 per diabetic patient per year |
Cost
= up to $190
Gross
Savings = up to $390 |
* Cost reflected
is an estimate. Interested employers should contact [email protected].
PDF presentation
detailing the BTE
Business Case and program measures
PDF presentation
of BTE
Program Overview
Roles
and Responsibilities
Bridges to Excellence
(BTE) involves the collaborative effort of many groups and
individuals. BTE essentially functions as a not-for-profit
company with a Board, including structured input from all
stakeholders. Below is a description of the overall program
organization structure and their roles:
Board - Advisory body
comprised of BTE purchaser participants, licensees and stakeholders,
that makes decisions on program strategy and direction.
Executive Committee -
Acts as the advisory and administrative body with a President,
Secretary and Treasurer.
Employer Advisory Board
- Advisory body comprised of BTE participating employers that
provides broad input into BTE topics and direction.
Administrator Committee
- Advisory body comprised of BTE Administrators (licensees
and partners) that reviews implementations and operational
topics.
Regional Team/Steering Committee
- Previous experience has shown that organized regional teams
with informal leaders have worked effectively to operate BTE
locally; however, regions can establish an operational team
structure that best meets their market and customer needs.
Overall, the regional team is responsible for regional coordination
and market engagement. Led by an identified informal leader,
the team includes all participants, stakeholders and allied
organizations.
Purchasers
Purchasers participating
in the BTE initiative have some key responsibilities
- Execute participation
agreement: agree to participate in the BTE project by signing
the BTE Participation Agreement
- Engage health
plans: engage all health plans with which the purchaser
contracts and which will be providing physician and patient
data for the BTE project
- Execute data
release agreements: work with health plans and Medstat to
execute any required data release agreements to permit the
health plan to transfer the purchaser's physician and patient
data to Medstat
- Pay rewards
and administrative fees: establish banking arrangements
with Medstat for the payment of physician rewards, Medstat
administrative fees, and other BTE-determined project fees;
ensure timely payment of all funds
- Communicate
with employees: distribute communications to employees regarding
BTE and participation in programs with disease management
tools and rewards
- Outreach to
region: participate in Regional Implementation Team, working
to improve region project performance, including participation
by physicians, employees, and new purchasers
Health
Plans
Health Plans participating
in the BTE initiative have the responsibility of executing
any of the required contracts and producing data files within
the timeframe of the regional implementation. Health Plans
can also play a key strategic role in recruiting physicians
for Bridges to Excellence participation. For more information
about licensing BTE as a health plan, please visit the Health
Plan Licensing section of this site.
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