BTE
Rewards Frequently Asked Questions (FAQ)
*Please note that some of the information
below could be specific to a region, for example reward amounts
and/or fee reimbursement. For market specifics, please contact
your local BTE
administrator.
Which
physicians are eligible for rewards?
The three Bridges
to Excellence (BTE) reward programs (POL, DCL, and CCL)
are targeted at doctors (MD's and DO's) who are primary
care physicians, endocrinologists, cardiologists, and neurologists.
These physicians and their office practices are eligible
to receive the rewards offered under the BTE programs if
they:
- provide care
for eligible patients identified by Bridges to Excellence
based on data supplied by the participating health plans
for the participating purchasers
- demonstrate
high levels of performance in BTE program content areas
by obtaining passing scores on NCQA's physician performance
measures for the BTE program
Physicians who
are
eligible to receive the rewards (PDF) offered through
Bridges to Excellence will be contacted by BTE and notified
of their eligibility. Bridges to Excellence is currently
active in the following market areas: Massachusetts (POL,
DCL, CCL), and Albany/Schenectady (POL, DCL, CCL).
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If
I'm eligible, how can I receive the rewards?
Primary
Care Physicians
Eligible primary care physicians (PCPs) can obtain the rewards
offered under the POL program if their office practice passes
NCQA's
office practice performance assessment program. After
obtaining POL rewards, PCPs also may be eligible to receive
rewards offered under the DCL and CCL programs, if they
have eligible diabetes and/or cardiac patients. To obtain
the rewards offered under the DCL program, PCPs must pass
NCQA's
diabetes care performance assessment program. To obtain
the rewards offered under the CCL program, PCPs must pass
NCQA's
cardiac care performance assessment program.
Endocrinologists
Eligible endocrinologists can obtain the rewards offered
under the DCL program if they pass NCQA's diabetes care
performance assessment program. Endocrinologists also can
receive the rewards offered under the POL program by passing
NCQA's office practice performance assessment program.
Cardiologists/Neurologists
Eligible cardiologists and neurologists
can obtain the rewards offered under the CCL program if
they pass NCQA's cardiac care performance assessment program.
Cardiologists and neurologists also can receive the rewards
offered under the POL program by passing NCQA's office practice
performance assessment program.
As
a PCP, endocrinologist, cardiologist, or neurologist, you
can simply follow the steps outlined in the BTE
Eligibility-Reward Diagram to receive your eligible
rewards.
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How
is my eligible patient count determined?
Each eligible
physician's reward amount is based on the count of eligible
purchaser patients treated by the physician. Eligible patients
are determined by Bridges to Excellence based on inpatient
and ambulatory claim and encounter data supplied by the
participating health plans for the participating purchasers.
Eligible patient counts are revised up to twice each year
based on new data supplied by health plans.
- POL: counts
are based on patients seen for office visits
- DCL: counts
are based on patients with a diagnosis of diabetes
- CCL: counts
are based on patients with a diagnosis of cardiovascular
disease or who have had a stroke
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How
much can I earn in rewards?
Eligible physicians
who pass NCQA's performance assessment criteria for office
practices, diabetes care, and cardiac care can receive the
following annual reward amount for each eligible patient
identified by BTE, up to $210 per patient:
- POL: up to
$50 annually (based
on the reward schedule)
- DCL: $80 annually
for each eligible diabetes patient treated
- CCL: up to
$160 annually for each eligible cardiac patient treated
The maximum per-physician
reward amount available through Bridges to Excellence is
$20,000 annually or $50,000 over the life of the BTE program.
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I
have rewards available-what do I do next?
If you have been
notified by Bridges to Excellence that you may be eligible
to receive rewards for one of the BTE reward programs, simply
follow the 1-page instructions below to obtain your reward:
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