Bridges to Excellence, which now recognizes and financially rewards 15,000 selected physicians for providing quality care nationwide, announced it will now be assessing the diagnosis, treatment, and management of new five chronic conditions: asthma, congestive heart failure, chronic obstructive pulmonary disease, coronary artery disease, and hypertension.
The new programs--combined with an existing focus on diabetes, ischemic vascular disease, back pain, and depression--are expected to cover the majority of conditions accounting for healthcare costs in the system today and the bulk of patients that many providers are seeing in their practices.
The Bridges to Excellence programs have been designed to provide incentives to reward physicians and practices for adopting better systems of care. At the inception of the program, emphasis had been placed on encouraging the adoption of systems of care--such as electronic medical records--along with using those systems in delivering good results in patient management. BTE works with large employers, health plans, providers, and other organizations that have a shared goal to improve quality and patient outcomes.
Now, the emphasis is being placed on results of patient management, specifically with chronic conditions. Physicians who demonstrate excellent performance can earn recognition and also qualify for incentives from participating employers and health plans.
Work at Bridges to Excellence has shown that significant avoidable costs exist with the management of these conditions, says Francois de Brantes, the Bridges to Excellence CEO. "By reducing preventable complications incurred by most patients with these chronic conditions, we could significantly improve the health of employees and save employers billions of dollars."
Bridges to Excellence uses "continuous scoring" meaning that physicians can get points that are calculated upon exactly how many patients they get into compliance, says Edison Machado, MD, Bridges to Excellence medical director and programs manager.
And to promote continuous quality improvement, the Bridges To Excellence physicians are monitored by using three levels or tiers of recognition. The levels are designed to recognize improvements in performance--from successfully managing the patients at the highest risk of hospitalization to optimally managing the majority of patients--while controlling for patient selection bias.
The levels are:
- Level I: Focuses on a "physician centric view" of measurement, with an emphasis placed on reducing the number of patients in "poor control" as assessed by intermediate outcome measures.
- Level II: Focuses on a combination of physician and patient centric measurements, which look at the defect rate of care delivery across the "poor control" measures on a per patient basis.
- Level III: Focuses on a patient centric view of measurement, with the defect rate strategy expanded to apply to "superior control" as well as "poor control" measures on a per patient basis.