Bridges to Excellence

What is the Blue Cross Bridges to Excellence program (BCBSTX BTE)?

Bridges to Excellence (BTE) is a family of programs to reward recognized physicians and other practitioners who meet certain performance measures for certain conditions including diabetes care.

The BTE programs are administered under the parent company of Health Care Incentives Improvement Institute, a nonprofit, national organization. BCBSTX has collaborated with BTE to implement the Diabetes Care Recognition program and the Cardiac Care Recognition program.

BTE is a national program offered in more than 20 states and recognizes thousands of physicians across the United States. Please refer to BTE’s Web site for additional details on all programs offered. BCBSTX has established a program in which BTE-recognized physicians can be financially rewarded for excellent care provided to our members with diabetes.

Why Participate in Bridges to Excellence through Blue Cross?

BCBSTX BTE Recognition programs offer practices the opportunity to evaluate and demonstrate the quality of care they deliver.

• The program gives physicians tools to continuously improve their practice and receive national recognition and incentives. In addition, patients will know that they are receiving care from BTE-recognized physicians. Being BTE recognized automatically ensures participation in the BCBSTX Recognition Programs and the potential to earn bonus payments. For all of their diabetes or cardiac care patients, BCBSTX will pay a BTE-recognized physician $100 per patient, per program year.  

  BTE has the potential to significantly improve the quality of care experienced by many patients and reduce the burden of unnecessary hospitalizations and complications. Based on historical results, BTE believes that if physicians participate in programs where they follow proven, evidence-based guidelines and submit data to validate performance, the quality of care they provide to patients with chronic diseases will improve.

What Else Do I Need to Know About BTE?

Here are the metrics for each clinical condition.

• To achieve BTE recognition in diabetes care, physicians must meet benchmarks on measures such as:
• Blood pressure
  LDL levels
  HgBA1c levels
  Ophthalmologic and podiatric exams
  Nephropathy assessment
• To achieve BTE recognition in cardiac care, physicians must meet benchmarks on measures such as:
• Blood pressure
  LDL control
  Lipid control
  Complete lipid profile
  Use of aspirin or another antithrombotic
  Smoking status and cessation advice and treatment

How Do I Participate in BTE?

Physicians must contract with a data aggregator, who will submit their data to BTE’s automated performance assessment process (see additional information on submitting data below).

To be eligible to participate, a physician must:

• Be licensed as a medical doctor (MD) or doctor of osteopathy (DO)
• Provide continuing care for at least 25 patients with diabetes or 25 patients with cardiac disease
• Use approved methods for submitting data electronically
• Learn the specifications and BTE measures
• Determine whether to apply as an individual physician or physician group

Once a physician becomes BTE recognized, BCBSTX will identify members with diabetes or cardiac disease that the physician manages. BCBSTX will ask the physician to send biometric information about the member. BCBSTX will then advise the physician that he or she is clear to submit a claim with a specific code for reimbursement.

Visit http://www.bcbstx.com/provider/training/bridges_excellence.html for more information.

How Do I Become BTE Recognized?

There are currently four different pathways available to physicians for recognition and data submission.

Details about these options are available at www.bridgestoexcellence.org.

What Other Resources for BTE Should I Be Aware Of?

Additional information for physicians is available on the BCBSTX website:

Diabetes:
BCBSTX Diabetes Care Program Guide
Diabetes Frequently Asked Questions

Cardiac care:
BCBSTX Cardiac Care Program Guide
Cardiac Care Frequently Asked Questions

Whom Do I Contact If I Have More Questions?

Please feel free to contact us with any questions.

Refer to these portions of the TMA website:

Deadlines for Doctors
Continuing Medical Education on Quality Improvement Topics
HIT
TMA Practice Consulting
Payment Advocacy
Cancer Control and Prevention

Or Contact the TMA Knowledge Center:
(800) 880-7955
knowledge[at]texmed[dot]org
Ask TMA

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