Day 1 Track 2 Whitney1

Bridges To Excellence: 

Bridges To Excellence www.bridgestoexcellence.org

Five Purchaser Principles: 

Five Purchaser Principles Effectiveness and efficiency must improve dramatically for current system to survive Health care efficiency and effectiveness can be improved using the same tools (IT & continuous process improvement) we use to improve quality and productivity in our businesses. Redesigning systems of care within practices and adopting better HIT systems to support the physician will improve quality and efficiency Purchasers and consumers will reward providers demonstrating the greatest effectiveness and efficiency 5. Short-term fixes are not long-term answers

Slide3: 

UPS 1985 UPS 2005 Information Technology has driven improvements in quality, productivity and customer satisfaction

Slide5: 

Test Question # 1 1985 or 2005 ?

We created a multi-stakeholder group and designed the program to meet diverse needs: 

We created a multi-stakeholder group and designed the program to meet diverse needs Mission: Improve quality of care through rewards and incentives that (1) encourage providers to deliver optimal care, and (2) encourage patients to seek evidence-based care and self-manage their own conditions Focus: Reengineer office practices by adopting better systems of care Demonstrate the reengineering is working through better outcomes for patients with chronic conditions, starting with diabetes and cardio-vascular diseases

The process for recognition and rewards is straightforward: 

The process for recognition and rewards is straightforward Physicians apply for recognition with NCQA NCQA send notify of physician being recognized to Medstat GC looks up physician/patient attribution by BTE Participant & Invoices purchasers GC bundles Participant payments and pays physician Instructions and toolkits are available at: www.bridgestoexcellence.com General Contractor

BTE uses standard nationally recognized measures of performance: 

BTE uses standard nationally recognized measures of performance Structure (PPC): Process & Outcomes (DPRP & HSRP): HbA1Cs tested and controlled LDLs tested and controlled BP tested and controlled Eye, Foot and Urine exams LDLs tested and controlled BP tested and controlled Use of aspirin Smoking cessation advice Patient safety – e-prescribing Guideline-driven care – EHRs Focus on high-cost patients – Care coordination Improved compliance – Patient education & support

Physician Office Link Savings: 

Physician Office Link Savings

There are three programs based on the NCQA Physician Recognition Measures: 

There are three programs based on the NCQA Physician Recognition Measures

We’ve Made Great Progress in Our Pilot Markets: 

We’ve Made Great Progress in Our Pilot Markets Bridges To Excellence, Proprietary & Confidential 1,896 Diabetes Care $8MM Available Rewards $1.4M Rewards paid to - date Office Systems Employees going to recognized Physicians Diabetes Care Office Systems 60 559 30 Physicians Recognized for Excellence Dec 2004 Jan 2004 Diabetes Care $8MM Available Rewards Rewards paid to - date 8,872 Office Systems Employees going to recognized Physicians Diabetes Care Office Systems 381 60 30 Physicians Recognized for Excellence Mar 2005 Jan 2004

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Additional Interest In Nearly 30 Markets

Program Success Factors: 

Program Success Factors Critical mass re: employer and plan volume of covered lives in specific markets – currently representing nearly 350,000 covered lives Active employer and health plan participation in each market – currently 13 large employers in 4 markets, 5+ new markets in 2005; Health Plans now becoming licensed agents for BTE. Buy-in by physician community – from 90 to over 800 new participating physicians in 2004 Aggressive Communications strategy - Press releases to highlight physician success and key messages, Newsletter, Electronic distribution, community presense Bridges To Excellence, Proprietary & Confidential

Physician Office Link (POL): 

Physician Office Link (POL) Measures Rewards Report Cards Bridges To Excellence, Proprietary & Confidential

POL: What is It?: 

POL: What is It? Specific process implementation reduces errors and increases quality Enables physician sites to qualify for bonuses Earn up to $50 annually per patient covered by participating employer or plan Report card created for each physician office Reports performance on program measures Report made available to public Bridges To Excellence, Proprietary & Confidential

POL: Program Description: 

POL: Program Description Bridges To Excellence, Proprietary & Confidential

BTE Incentives For PCPs: 

BTE Incentives For PCPs

Physician Quality Ratings: Rating and Rank: 

Physician Quality Ratings: Rating and Rank High-level roll-up of physician’s overall performance Distinguishes relative performance of physicians within each level Patients can express satisfaction or dissatisfaction about their primary physician Bridges To Excellence, Proprietary & Confidential http://www.bridgestoexcellence.com/bte/qualityratings

We’re going to continue building programs to cover most specialties: 

We’re going to continue building programs to cover most specialties 2007 2006 2005 PPC version 2.0 + All Docs PCPs (IM, FP, Gyn, Ped, etc.) PCP Recognition Program Patient Experience of Care Ortho & Rheum MSK RP Oncologists Cancer RP Endo DPRP Cardio & Neuro HSRP

Our efforts have been incorporated in other national initiatives: 

Our efforts have been incorporated in other national initiatives HRPA – the coalition has agreed to use the BTE & Leapfrog-defined measure sets in its initiative, and will only contract with plans that agree to use them CMS – we’re working with CMS on three of its demos: CMP, DOQ, DOQ-IT to make sure that our performance measures are synched up Health Plans – UHC has licensed BTE for their customers, along with CIGNA, CareFirst BCBS and NBCH

Participation in Bridges to Excellence: 

Participation in Bridges to Excellence Use the available BTE resources and experts Work with BTE Licensee to engage the market Lay of the land Key stakeholders Build the team Develop communications plan Build sense of urgency Sign BTE/Licensee/Health plan contracts Communicate to the market Create momentum Evaluate and tweak