The BTE programs are administered under the parent company of Health Care Incentives Improvement Institute, a nonprofit, national organization. BCBSTX has collaborated with BTE to implement the Diabetes Care Recognition program and the Cardiac Care Recognition program.

BTE is a national program offered in more than 20 states and recognizes thousands of physicians across the United States. Please refer to BTE’s Web site for additional details on all programs offered. BCBSTX has established a program in which BTE-recognized physicians can be financially rewarded for excellent care provided to our members with diabetes.

The program gives physicians tools to continuously improve their practice and receive national recognition and incentives. In addition, patients will know that they are receiving care from BTE-recognized physicians. Being BTE recognized automatically ensures participation in the BCBSTX Recognition Programs and the potential to earn bonus payments. For all of their diabetes or cardiac care patients, BCBSTX will pay a BTE-recognized physician $100 per patient, per program year.  

BTE has the potential to significantly improve the quality of care experienced by many patients and reduce the burden of unnecessary hospitalizations and complications. Based on historical results, BTE believes that if physicians participate in programs where they follow proven, evidence-based guidelines and submit data to validate performance, the quality of care they provide to patients with chronic diseases will improve.

To achieve BTE recognition in diabetes care, physicians must meet benchmarks on measures such as:

• Blood pressure
• LDL levels
• HgBA1c levels
• Ophthalmologic and podiatric exams
• Nephropathy assessment

To achieve BTE recognition in cardiac care, physicians must meet benchmarks on measures such as:

• Blood pressure
• LDL control
• Lipid control
• Complete lipid profile
• Use of aspirin or another antithrombotic
• Smoking status and cessation advice and treatment

To be eligible to participate, a physician must:

• Be licensed as a medical doctor (MD) or doctor of osteopathy (DO)
• Provide continuing care for at least 25 patients with diabetes or 25 patients with cardiac disease
• Use approved methods for submitting data electronically
• Learn the specifications and BTE measures
• Determine whether to apply as an individual physician or physician group

Once a physician becomes BTE recognized, BCBSTX will identify members with diabetes or cardiac disease that the physician manages. BCBSTX will ask the physician to send biometric information about the member. BCBSTX will then advise the physician that he or she is clear to  submit a claim with a specific code for reimbursement.  

Visit http://www.bcbstx.com/provider/training/bridges_excellence.html for more information.

Details about these options are available at www.bridgestoexcellence.org

Jill Brooks, RN
Medical Program Specialist
972-766-6397 
Jill_Brooks@bcbstx.com

Rebecca Ford, RHIA
Senior Manager, Texas Health Information
972-766-8234
Rebecca_Ford@bcbstx.com

Diabetes:

• BCBSTX Diabetes Care Program Guide
• Diabetes Frequently Asked Questions

Cardiac care:

• BCBSTX Cardiac Care Program Guide
• Cardiac Care Frequently Asked Questions

Refer to these portions of the TMA website:

Deadlines for Doctors 
Continuing Medical Education
HIT
TMA Practice Consulting
Payment Advocacy
Physician Oncology Education Program  (POEP)  

Or Contact the TMA Knowledge Center:
(800) 880-7955
knowledge@texmed.org
Ask TMA 

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