ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2016
A population-based analysis of incentive payments to primary care physicians for the care of patients with complex disease.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Effects of pay-for-performance for primary care physicians on diabetes outcomes in single-payer health systems: a systematic review.The European journal of health economics : HEPAC : health economics in prevention and care · 2019Pooled it
- Financial incentives and information provision for post-pandemic primary care quality recovery: a longitudinal study in Catalonia.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Chronic Disease Management Among People Treated for Comorbid Serious Mental Illness and/or Substance Use Disorders: A Population-Based Observational Study.Community mental health journal · 2026Article
- The Effect of an Incentive Billing Code on Heart Failure Management in Primary Care: A Population-Based Study.CJC open · 2025Article
- Will blended family physician payment models revive primary care in Canada?Canadian family physician Medecin de famille canadien · 2025Article
- Do compensation models affect family physician job satisfaction? Scoping review.Canadian family physician Medecin de famille canadien · 2025Article
- Information provision and financial incentives in Catalonia's public primary care (2010-2019): an interrupted time series analysis.The Lancet regional health. Europe · 2024Article
- Population-Based Trends in Complexity of Hospital Inpatients.JAMA internal medicine · 2024Article
- Association of a Heart Failure Management Incentive in Primary Care With Clinical Outcomes: A Retrospective Cohort Study.Journal of the American Heart Association · 2024Article
- Productivity Decline or Administrative Avalanche? Examining Factors That Shape Changing Workloads in Primary Care.Healthcare policy = Politiques de sante · 2023Article
- Pharmacists' chronic disease management in chronic obstructive pulmonary disease: Effect on health services utilization.Journal of managed care & specialty pharmacy · 2023Article
- Impact of prevention in primary care on costs in primary and secondary care for people with serious mental illness.Health economics · 2023Article
- Physician Financial Incentives to Reduce Unplanned Hospital Readmissions: an Interrupted Time Series Analysis.Journal of general internal medicine · 2021Observational
- Development of comparable algorithms to measure primary care indicators using administrative health data across three Canadian provinces.International journal of population data science · 2020Article
- Policy-induced selection bias in pharmacoepidemiology: The example of coverage for Alzheimer's medications in British Columbia.Pharmacoepidemiology and drug safety · 2019Article
- Effect of primary health care reforms in the province of Newfoundland and Labrador: Interrupted time-series analysis.Canadian family physician Medecin de famille canadien · 2019Article
- Gendered effects of pay for performance among family physicians for chronic disease care: an economic evaluation in a context of universal health coverage.Human resources for health · 2019Article
- Trends in Providing Out-of-Office, Urgent After-Hours, and On-Call Care in British Columbia.Annals of family medicine · 2019Article
- Aligning innovations in health funding with innovations in care.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2018Article
- Reflections of the quality of primary care in Canada and Israel.Israel journal of health policy research · 2018Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 2007, the province of British Columbia implemented incentive payments to primary care physicians for the provision of comprehensive, continuous, guideline-informed care for patients with 2 or more chronic conditions. We examined the impact of this program on primary care access and continuity, rates of hospital admission and costs.
methodsWe analyzed all BC patients who qualified for the incentive based on their diagnostic profile. We tracked primary care contacts and continuity, hospital admissions (total, via the emergency department and for targeted conditions), and cost of physician services, hospital care and pharmaceuticals, for 24 months before and 24 months after the intervention.
resultsOf 155 754 eligible patients, 63.7% had at least 1 incentive payment billed. Incentive payments had no impact on primary care contacts (change in contacts per patient per month: 0.016, 95% confidence interval [CI] -0.047 to 0.078) or continuity of care (mean monthly change: 0.012, 95% CI -0.001 to 0.024) and were associated with increased total rates of hospital admission (change in hospital admissions per 1000 patients per month: 1.46, 95% CI 0.04 to 2.89), relative to preintervention trends. Annual costs per patient did not decline (mean change: $455.81, 95% CI -$2.44 to $914.08).
interpretationBritish Columbia's $240-million investment in this program improved compensation for physicians doing the important work of caring for complex patients, but did not appear to improve primary care access or continuity, or constrain resource use elsewhere in the health care system. Policymakers should consider other strategies to improve care for this patient population.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.