Annals of Family Medicine: Team-based Primary Care, Coupled With Payment Reform, May Reduce Emergency Department Use

ANN ARBOR, Mich., Jan. 25, 2022 /PRNewswire/ -- In a new paper published in the Annals of Family Medicine, researchers observed an increase in emergency department use by patients whose physicians had transitioned from an enhanced fee-for-service payment model to either a team-based or non-team-based blended capitated payment model. However, post-transition period, this increase was seen to be smaller in those patients who received team-based care.

Under capitated payment models, practices are paid a fixed monthly fee for taking care of a specific group of patients rather than by the visit. Such models are designed to enable physicians to spend more time with patients; address multiple problems in an encounter; and better communicate with patients, family, and team members. care.

The researchers compared annual ED visit rates of approximately 2.5 million patients in Ontario, Canada, before and after the transition from an enhanced fee-for-service to either a team-based or a non-team-based blended capitation model. Data was collected between April 1, 2003, and March 1, 2017.

Specifically, they compared ED visit rates in big cities, small towns and rural areas following the payment transition between 2006 and 2013. In big cities, the ED visit rate increased by 2.38% per year for patients who received team-based care and 5.23% per year for patients who did not. These figures accounted for differences in patient age, sex, neighborhood, income, recent immigration status, morbidity and comorbidity. Similar trends were observed among patients in small towns and rural areas.

The paper's authors assert that team-based care is a critical component of effective primary care and could help patients access primary care without having to rely on emergency departments for health issues.

Sharing care responsibilities within an interprofessional primary care team, coupled with payment reform, may improve patient care while also reducing family physician burnout.  

The research team includes members from the Institute for Clinical Evaluative Sciences (ICES); the Department of Family and Community Medicine and the MAP Centre for Urban Health Solutions at St. Michael's Hospital; and the Department of Family and Community Medicine and the Institute of Health Policy, Management and Evaluation, both at the University of Toronto.

Impact of Team-Based Care on Emergency Department Use
Tara Kiran, MD, MSc, et al.
St. Michael's Hospital, Unity Health Toronto                       

SOURCE Annals of Family Medicine