cians earn maximum points if 60 percent or more of their patients have a blood pressure of less than 140/90 or an LDL cholesterol level of less than 130 milligrams per deciliter.
Additional process measures re-
cord whether patients are getting routine ophthalmology, nephropa- thy, and podiatry examinations. For cardiac care, the measures included blood pressure and LDL cholesterol control, as well as whether the physician did a com- plete lipid profile, used aspirin or another antithrombotic, and carried out smoking status evalu- ation and cessation advice and treatment.
Bridges to Excellence was founded in 2002 to improve the quality of care. “It was a program that really in- volved recognizing and rewarding providers who met evidence-based performance measures and qual- ity standards,” said Chad J. Brown, MPH, MBA, program implemen- tation leader for the Health Care Incentives Improvement Institute (HCI3), a not-for-profit organiza- tion that runs Bridges to Excel- lence, along with another program called Prometheus Payment that focuses on paying physicians for episodes of care. A board of directors that in- cludes physicians, employers, health plans, and others runs HCI3. Bridges to Excellence is the only program of its kind in the country. Log on to http://www
.hci3.org/ for more information about the program. Bridges to Excellence offers physicians recognition (or certifi- cation) in 13 different programs, including diabetes, cardiac care, hypertension, and spine care. Mr. Brown says 28,924 physicians na- tionally have gained recognition in one or more of those programs, including 1,407 Texas physicians. So far, 360 Texas physicians
participate in the BCBSTX diabe- tes program, earning $968,200 in
TAKING THE RIGHT PATH
Once you’ve decided you want to participate in Bridges to Excellence, you may follow one of four pathways to achieve recognition. Officials from both Blue Cross and Blue Shield of Texas and TMA say
the fastest and easiest way is through the IPRO Direct Submission Portal at
http://pao.ipro.org/. It costs $95 per physician or $295 per practice for three or more physicians. Using the IPRO portal, physicians or their staff would extract data
from 25 patients with either diabetes or cardiac disease from patient charts or electronic medical record (EMR) systems, place the data into a standard file format, and upload it via the web portal for assessment. Physicians also can submit data directly from their EMR or registry
systems. Their EMR or registry vendor would extract patient data and submit it to MN Community Measurement or IPRO on the physician’s behalf. There is no charge for this service. Currently, only four EMR vendors participate in the Bridges to Excellence program: GE Healthcare, Next- Gen, AthenaHealth, and CINA. If your vendor is not on the list, you must select the IPRO portal for electronic submission. For more information on this pathway, go to
www.hci3.org. Two other pathways to Bridges to Excellence recognition are the
National Committee for Quality Assurance (NCQA) and the American Board of Internal Medicine (ABIM). Physicians who gain NCQA recognition in diabetes or cardiac disease
are automatically eligible for Bridges to Excellence recognition, but BCB- STX officials say that process is more arduous than using the IPRO portal or EMR submission. It also is more expensive. NCQA charges $80 for program materials, plus a $500 data collection fee. BCBSTX physicians, however, can get a 20-percent discount, reducing the data collection fee to $400. The up- side of the NCQA path is it gains you Bridges to Excellence recognition for three years, whereas the other pathways are good for only two years of recognition. More information on NCQA is at
www.ncqa.org. Physicians also can attain Bridges to Excellence recognition in diabe-
tes care by completing the ABIM maintenance-of-certification module in diabetes. For more information on ABIM’s maintenance-of-certification offerings, visit the ABIM web site at
www.abim.org. In addition to fees charged by ABIM for its maintenance-of-certifica-
tion products, there is an additional $95 charge for IPRO assessment of the ABIM data. More information on the Bridges to Excellence pathways is available online at
www.texmed.org/bte/aspx.
October 2011 TEXAS MEDICINE 19
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