Team-based care has been proven to reduce risk factors in patients and is considered cost-effective for healthcare systems, but it can be financially detrimental to primary care practices operating in a fee-for-service environment, according to a recent study.
The study, published by the American Journal of Managed Care, found coordinating team-based care for patients with coronary heart disease came at a net cost of $291 per patient per year.
To determine this, researchers conducted a trial in 5 primary care clinic sites that involved delivering team-based care for patients with coronary heart disease. They then compared the cost of care delivery under this model, differences in the average number of visits per patient and changes in revenue. Researchers tracked an improvement among patient risk factors and medication adherence using team-based care, but the system was not revenue-neutral or positive. Revenue per visit increased, but the average number of visits decreased so that the practice experienced a 2.5 percent drop in revenue per patient.
These costs could be recouped under an accountable care organization if the team-based care is able to reduce overall healthcare costs — including outpatient and inpatient admissions, emergency department visit and medication costs. Then the primary care practice would be able to share in savings to offset the costs of the team-based model. However, under a fee-for-service model, the additional costs incurred by team-based care are borne by the primary care practice, the authors concluded.
"This suggests that primary care practices will not adopt team-based care and their patients will not experience the benefits until new payment models are developed and implemented," the authors wrote.
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