Bridges to Excellence

Bridges to Excellence Provider Incentive Program

To address widespread diabetes and asthma issues in Texas, Superior HealthPlan is now a proud partner of Altarum’s Bridges to Excellence® (BTE) Diabetes and Asthma Care Incentive Programs. These BTE Incentive Programs are clinician recognition programs intended to identify clinicians who deliver high-value care to patients with diabetes and asthma. Studies demonstrate that participation in BTE programs leads to improved provider performance, better patient health and reduced costs-of-care.

BTE has recognition programs for health-care professionals who work with asthma and diabetes patients. Each program has three levels of recognition; 3 star, 4 star and 5 star for diabetes care and I, II, III for asthma care, each indicating a different performance level.

Once recognized, providers are eligible for incentive programs from health plans, like Superior, as well as entry in Altarum’s Inquire system. Inquire is a consumer resource for finding high-quality providers, and is available online or through a mobile application.

In addition to financial incentives, another benefit includes displaying the BTE recognition within the Superior Provider Directory as well as on the consumer portal, INQUIREhealthcare.org. Superior providers who are BTE recognized in asthma, have an open panel with Superior and want to enroll in the incentive program, should contact the Clinical Nurse Liaison assigned to their area or email SuperiorProviderPrograms@superiorhealthplan.com

For more information, visit http://www.BridgesToExcellence.org/clinicians-participate-bte, email bte@altarum.org or download a copy of the BTE Program Brochure (PDF)

According to the Texas Health Institute, diabetes affects one in three Texans and costs the state more than $12.5 billion a year. The number of adult Texans with diabetes is expected to quadruple over the next three decades to nearly 8 million.

Superior’s BTE Diabetes Care Incentive Program is comprised of a set of clinical measures representing standards of care for diabetic patients and has three performance thresholds translating to 3 stars (“above average”), 4 stars (“very good”) or 5 stars (“exceptional”) recognition. The program uses standardized sets of measures and criteria to analyze quality of care, including AQA/NQF-endorsed and NCQA-developed measures.

In addition, many of the BTE program measures align with the Physician Quality Review System (PQRS) program. For more information regarding the program measures and the scoring, visit http://www.bridgestoexcellence.org/.

The program pays a per member, per year bonus ranging from $100-150, depending on the recognition level.

According to Texas Department of State Health Services 10,075 Texas children were hospitalized due to asthma and more than half (54.2%) were Medicaid beneficiaries. In total, more than $97 million dollars were spent on asthma-related care for children on Medicaid in 2012.

Superior’s BTE Asthma Care Incentive Program is comprised of a set of clinical measures representing standards of care for Asthma patients and has three performance thresholds translating to First Tier (“above average”), Second Tier (“very good”) or Third Tier (“exceptional”) recognition. The program uses standardized sets of measures and criteria to analyze quality of care, including AQA/NQF-endorsed and NCQA-developed measures.

In addition, many of the BTE program measures align with the Physician Quality Review System (PQRS) program. For more information regarding the program measures and the scoring, visit http://www.bridgestoexcellence.org/.

The program pays a per member, per year bonus ranging from $50-100, depending on the recognition level. Also a $25 per member per year ($6.25 a quarter) bonus will be paid to BTE asthma providers who have 57 or less potentially preventable per 1000 member months.

There are three ways in which a Superior provider can become BTE recognized:

1. The automated EMR/Registry System: Providers must have Electronic Medical Record (EMR) data or electronic data in a patient registry or have the internal technology and resource capability to do the standard extract. Participating EMRs include:

  • athenahealth
  • eClinical Works
  • Meditab
  • Meridios

2. BTE Application hosted by Altarum: Go to https://portal.bridgestoexcellence.org/login to apply and submit clinical data. Listen to the step-by-step tutorial on the home page. 

Quantity of data captured, submission process and costs to apply vary.