According to research published in in the Canadian Medical Association Journal (CMAJ), switching doctors from fee-for-service payment and adding interprofessional health providers to the team appears to result in moderately improved diabetes care for Ontario patients.
“Our study suggests that Ontarians might be healthier if everyone had access to team-based care” said Dr. Tara Kiran of St. Michael’s Hospital Academic FHT and one of its authors.
Based on data from the Ontario Health Insurance Plan (OHIP) and the Institute for Clinical Evaluative Sciences (ICES) on more than 10 million patients, this longitudinal study asked whether the move of physicians to blended capitation models with care provided by a health care team improved patient outcomes.
FHT patients were 22% more likely to receive recommended diabetes testing, more likely to be monitored for diabetes (40% v. 32%), to undergo screening for breast cancer (77% v. 72%) and colorectal cancer (63% v. 61%), than those in a fee-for-service practice. They experienced the greatest improvements in diabetes care over time but had similar improvements in mammography and colorectal cancer as non-FHT patients.
With capitation payment, instead of a fee per service provided, physicians earn a set fee per patient per year, regardless of the number of patient visits. Since 2002 in Ontario, 45% of primary care physicians have moved to capitation payment and approximately half of these physicians are with a FHT.
The authors, which include Dr. Rick Glazier, Alexander Kopp and Dr. Rahim Moineddin of ICES, also note that while these measures have the potential to improve quality of care, this needs to be weighed against the cost of reforms.
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