Bridges to Excellence--recognizing high-quality care: analysis of physician quality and resource use.
OBJECTIVE
To examine whether physicians who sought and received Bridges to Excellence (BTE) recognition performed better than similar physicians on a standardized set of population-based performance measures.


METHODS
Cross-sectional comparison of performance data.


METHODS
Using a claims dataset of all commercially insured members from 6 health plans in Massachusetts, we examined population-based measures of quality and resource use for physicians recognized by the BTE programs Physician Office Link and Diabetes Care Link, compared with nonrecognized physicians in the same specialties. Differences in performance were tested using generalized linear models.


RESULTS
Physician Office Link-recognized physicians performed significantly better than their nonrecognized peers on measures of cervical cancer screening, mammography, and glycosylated hemoglobin testing. Diabetes Care Link-recognized physicians performed significantly better on all 4 diabetes process measures of quality, with the largest differences observed in microalbumin screening (17.7%). Patients of Physician Office Link-recognized physicians had a significantly greater percentage of their resource use accounted for by evaluation and management services (3.4%), and a smaller percentage accounted for by facility (-1.6%), inpatient ancillary (-0.1%), and nonmanagement outpatient services (-1.0%). After adjustment for patient age and sex, and case mix, Physician Office Link-recognized physicians had significantly fewer episodes per patient (0.13) and lower resource use per episode (dollars 130), but findings were mixed for Diabetes Care Link-recognized physicians.


CONCLUSIONS
Our findings suggest that the BTE approach to ascertaining physician quality identifies physicians who perform better on claims-based quality measures and primary care physicians who use a less resource-intensive practice style.
Department of Health Policy and Management, Harvard School of Public Health, Boston, MA 02115, USA. meredith_rosenthal@harvard.edu
Meredith B
MB
Rosenthal
Francois S
FS
de Brantes
Anna D
AD
Sinaiko
Matthew
M
Frankel
Russell D
RD
Robbins
Sara
S
Young
D000328:Adult; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts; D010818:Practice Patterns, Physicians' / Q000145:classification / Q000191:economics*; D011787:Quality of Health Care / Q000145:classification* / Q000191:economics*