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QUALITY


Recognition and reward TMA supports Bridges to Excellence model


BY AMY LYNN SORREL Phy- sicians have always been dedicated to improving the health of their patients, but they want to be com- pensated for it. Health plans and employers want to see costs come down alongside those quality im- provements. The Bridges to Excellence (BTE) program is one place where all of those interests intersect, says Lisa Ehrlich, MD, chair of the Texas Medical Asso- ciation’s Council on Health Care Quality.


As the national quality


recognition program gains momentum in Texas, “this is an area of involvement in quality that physicians, patients, and health plans are all impacted positively,” the Houston internist said. Physicians in the Lone Star State “can now be compen- sated for delivering this care, while at the same time providing savings in the system.”


That’s a major reason the council and the TMA


House of Delegates in May voted to support best-practice mod- els like Bridges to Excellence to help physicians prepare for a value-based care system that will start paying them based on quality measures. The council also developed a toolbox to help physicians determine whether BTE participation makes financial sense for their individual practices. BTE is a recognition program that measures the quality of


care delivered by physicians and other clinicians. Many pay- ers have adopted the program to financially reward those


who earn BTE recognition. The program emphasizes managing patients with chronic conditions and of- fers recognition in more than a dozen different areas, including diabetes, cardiac care, depression, and medical home readi- ness. Roughly 3,000 Texas physicians participate in at least one BTE recognition program.


More payers adopting the Bridges to Excellence program means more opportunity for physicians like Houston internist Lisa Ehrlich, MD, to receive financial rewards for their work delivering quality patient care.


Since 2009, BTE-rec- ognized physicians in the Blue Cross and Blue Shield of Texas (BCBSTX) net- work are eligible for cash bonuses for meeting evi- dence-based clinical per- formance standards in dia- betes care. The health plan added cardiac and asthma care modules in 2010 and 2013, respectively. In mid- 2012, Aetna began offer- ing the BTE Diabetes Care Recognition Program for physicians who treat mem- bers of the Teacher Retire- ment System of Texas. Whereas some payer programs rely solely on


claims data to issue quality rankings on physicians, TMA’s Council on Health Care Quality found that BTE uses standard- ized sets of measures and criteria to analyze care quality. BTE draws those measures from nationally recognized organiza- tions, including the National Quality Forum, the American Medical Association, the Physician Quality Reporting System (PQRS), and the National Committee for Quality Assurance (NCQA). Also, a panel of primary care physicians and special- ists help develop each program.


September 2013 TEXAS MEDICINE 59


MATT RAINWATERS


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