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Improving diabetes care by testing a new remuneration scheme for endocrinologists

Stephen Paul

Everyone agrees that paying for services on a fee-for-service basis doesn't do enough to promote the delivery of high-value care. An alternative payment scheme for endocrinologists was developed by Our Enterprise, an integrated payer provider with headquarters in Pittsburgh. In line with our strategy, endocrinologists' responsibilities will gradually transition from clinical to more collaborative roles with their primary care counterparts. This change enables endocrinologists to assist primary care physicians in managing patients with diabetes and other endocrine-related illnesses while reducing the number of traditional in-office referrals to endocrinology. This is because the majority of patients with diabetes are managed under primary care. . Despite the unforeseen changes brought on by COVID, we saw its effects on care delivery and the connection between participating specialists and PCPs throughout the first nine months of the compensation model. Improvements in diabetes-specific quality indicators have been observed in practice- and provider-level quality data. 16 target practices of the 54 target practices received NCQA recognition for managing diabetes in just one year. 88% of all participating PCPs reported being at least 90% satisfied with the new plan. In the end, our model holds promise as a substitute for fee-for-service remuneration, with a chance of reducing costs and raising treatment quality.

Publicación de revisión por pares para asociaciones, sociedades y universidades pulsus-health-tech