Health Plans and Employers across the country have implemented BTE for their recognition and reward programs.
Recent implementations include:
- Aetna is paying out cash rewards for physicians who achieve Recognition under the BTE Diabetes Care Recognition program in select markets.
- The Aetna Aexcel Network has received endorsement from BTE and includes specialties such as Cardiology, Cardiovascular surgery, Neurology, Orthopedics, Gastroenterology, General surgery, Plastic surgery, OB/GYN, ENT, Urology, Vascular surgery.
- The Anthem-Quality-Insights program is offered nationally, but in CO, GA, and NY the program incorporates and assigns significant credit for external recognition including BTE or NCQA recognition. Evaluation is based on five components, 2 of which include a BTE or NCQA recognition as an option to fulfilling the criteria. It is a group level assessment for practices that have a minimum number of Anthem members.
- Blue Precision: Anthem’s Blue Precision program is a transparency program based on quality and efficiency metrics. The BTE recognitions are also used as part of the quality criteria in the Blue Precision program.
BlueCross BlueShield of Texas
- BCBS TX initially started with the Diabetes Care Recognition program. After successfully increasing the number of Recognized physicians throughout Texas that provide quality care to patients with diabetes, BCBS TX expanded its sponsorship to include implementing the Cardiac Care Recognition program. The goal of both statewide programs is to improve the care provided to patients diagnosed with diabetes and cardiovascular disease, and to financially reward BCBS TX network physicians for providing exceptional care. BCBS TX is the only health insurer to implement both programs statewide in Texas.
Colorado Business Group on Health
- The Colorado Business Group on Health(CBGH) is currently engaged in implementing the BTE Diabetes Care Recognition and Cardiac Care Recognition programs in Colorado Springs. The coalition had previously implemented a diabetes education initiative in Colorado Springs that focused on improving the detection, education and benefit-design structure for consumers with diabetes. Among its consumer tools, CBGH also publishes an annual health plan report card called Health Matters. CBGH is an employer-focused coalition serving the entire state of Colorado that continues to promote improvements in healthcare quality through pay-for-performance programs like BTE.
- The CIGNA Care Designation is a BTE-endorsed network designation for CIGNA’s commercial population. The program includes Family practice and 21 specialty categories with 20 score able opportunities.
Maine Health Management Coalition
- After experiencing success with its local Pathways to Excellence (PTE) primary care practice initiative, the Maine Health Management Coalition (MHMC) transitioned to BTE’s national platform. Practices are recognized for use of clinical systems and excellence in diabetes or cardiac care. The implementation of BTE increases opportunities for practices to achieve recognition (year round vs. annual), reduces the potential for duplicative reporting, and speeds up cycle time between the time a practice reports and receives their results on which to take improvement action.
Superior HealthPlan – Centene Corporation
- Superior HealthPlan is implementing the Diabetes Care Recognition program as the first Texas Medicaid plan to recognize and financially reward network clinicians who are dedicated to delivering exceptional care to diabetic patients.
- The United Premium Designation is a BTE-endorsed network designation that uses evidence-based and expert physician-derived consensus standards to evaluate physicians across 20 specialties using claims data for quality and cost efficiency. A physician board certified in internal medicine and in a market where Premium is available would receive the Premium Quality designation if they are BTE-Recognized as an individual physician for Asthma, Cardiac, CAD, CHF, Diabetes, or Spine.