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Mid-Atlantic Business Group On Health
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Bridges to Excellence Physician Reward Initiative

In response to MABGH demand, both Aetna and CareFirst BlueCross BlueShield have incorporated Bridges to Excellence (BTE) into their physician rewards systems. Bridges to Excellence is a payment model that rewards the physicians for demonstrating excellence in processes and outcomes.

The model is based on these premises:

  1. Care to patients needs to be improved: for example, diabetes patients receive all recommended care only about 50% of the time
  2. Physicians should be rewarded on the basis of evidence-based performance standards, which are linked to savings.
  3. Rewards systems should be standardized to prevent confusion and clutter.

Bridges to Excellence has demonstrated an ROI on all of its programs:

  • Diabetes Care Link savings = $350 per patient per year (typical payment: $100)
  • Physician Office Link savings = $110 per patient per year. (typical payment: $50)
  • Cardiac Care Link savings between $270 - $540 per patient per year. (typical payment: $160)

What can Employers Do?

  1. Participate in the eValue8 Health Plan Performance Initiative, and monitor the plans’ performance on payment reforms like BTE.
  2. Weight health plan purchasing decisions heavily on their participation in BTE as a payment reform mechanism.
  3. Select BTE accredited physicians as high performance providers, and use financial incentives to steer employees to these physicians.

Resources:

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