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Team-Based Physician Strategy May Further Improve Diabetes Care

Pay changes and team-based care changed diabetes care.

Research was recently published in the Canadian Medical Association Journal as an evaluation of various health care outcomes and physician pay and health care team organization. A push towards exploring new ways to provide efficient primary care inspired the study to review various models and disease states in 10 million patients.

In Canada, many physicians are moving away from free-for-service and towards a salaried or capitation payment. Basically, physicians are paid a set fee per year for an individual patient regardless of how many visits they make. Moreover, nearly 45% of physicians in Canada work in a healthcare team-based environment.

 

The study took data from Ontario health insurance plans and the Institute for Clinical Evaluative Sciences and assessed the monitoring of diabetes for patients with team-based capitation settings versus fee-for-service patients.

 

Overall, those patients in a team-based capitation setting receiving diabetes monitoring 39.7% of the time versus 31.6% of the time in a fee-for-service setting. With adjustments for patient and physician factors, patients cared for by family health teams were 22% more likely to receive recommended diabetes testing.

 

The study concluded it is evident that a team-based capitation service model is a shift that could lead to better diabetes care. In comparison, the evidence of evaluating various cancer screening in fee-for-service or capitation settings was less clear.

Nonetheless, this study indicates that there is incentive to provide better diabetes monitoring and care in a team-based capitation setting than a fee-for-service model. Research will continue to search for other factors and models that may improve patient care.

 

Practice Pearls:

  • A Canadian study compared the outcomes of patient care with a team-based capitation system to a fee-for-service setting.
  • The study found that diabetes monitoring and care was better in the team-based capitation setting with a 22% more likelihood to receive recommended testing.
  • A shift in the healthcare model could impact healthcare and patients outcomes, but more research needs conducted to evaluate various strategies.

Kiran T, A Kopp, R Moineddin et al. “Longitudinal evaluation of physician payment reform and team-based care for chronic disease management and prevention.” CMAJ (2015). Web. 25 Sept. 2015. <http://www.cmaj.ca/content/early/2015/09/21/cmaj.150579.abstract?sid=c6620c0c-4086-4d5a-9255-d802bba2e7c9>.