Gastroenterologists are increasingly facing a demand for quality-of-care reporting from payors and purchasers, and reporting to multiple programs means redundant work and inconsistent results. The AGA recognizes that to make quality reporting and rewards available to all gastroenterologists, there must be a framework which is consistent, evidence based, and minimally burdensome.
In response to this need, the AGA has partnered with the Health Care Incentives Improvement Institute (HCI3) to create Bridges to Excellence (BTE) IBD Care Recognition, the first BTE program for GI. This program provides GIs with the ability to quickly demonstrate their quality of care to a multitude of payors and purchasers, using nationally- approved GI measures that fairly and accurately demonstrate performance.
BTE IBD Care Recognition is the first BTE recognition program focusing on digestive health. It will enable gastroenterologists to demonstrate quality using measures designed by GI experts; many of the measures have been approved by the AMA’s Physician Consortium for Performance Improvement and are included in CMS’ Physician Quality Reporting System (PQRS). Applicants to the program can also opt to submit their data to CMS to meet PQRS requirements, providing a one-stop shop for both private and public payor quality reporting.
"Meeting the quality reporting requirements of several payors and other stakeholders, using a different set of rules for each, demands a tremendous amount of time and patience," says Dr. Lawrence Kosinski, MBA, AGAF, Cchair of the AGA Institute Practice Management and Economics Committee. "BTE IBD Care Recognition is a revolutionary way for GIs to report quality to health care payors and purchasers using a simple process, and meet Medicare PQRS requirements at the same time."
Eligible applicants include MDs, DOs, nurse practitioners, and physician assistants who have treated at least 30 IBD patients within the previous year. Applicants answer a set of clinical questions for each of these patients, and these data are then evaluated by an independent quality assessment organization to determine performance rates for the following measures:
1. Corticosteroid-sparing therapies.
2. IBD Ttype, anatomic location, and activity assessed.
3. Bone loss assessment.
4. Influenza immunization.
5. Pneumococcal immunization.
6. Testing for latent tuberculosis before initiating anti-tumor necrosis factor (TNF) therapy.
7. Assessment of hepatitis B virus before initiating anti-TNF therapy.
8. Tobacco screening and cessation counseling.
9. Thiopurine methyltransferase assessment.
Applicants who meet a minimum total score across these measures will be recognized by the AGA and BTE as quality providers of IBD care for a period of two years, and BTE will notify health plans so that they can determine what rewards they would like to extend for this designation.
The applicants who achieve recognition receive a certificate and the right to advertise as a BTE-recognized provider, demonstrating a commitment to quality care to current and prospective patients.
Applicants can also use this program to meet CMS PQRS reporting requirements for 2012, thus it provides a single point of entry for both health plan recognition and PQRS participation.
For more information on this new program, visit www.agarecognition.org, or e-mail recognition@gastro.org.
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