Study finds physician incentives not enough to improve complex patient care

A program that offers incentives for B.C.’s primary care physicians to care for patients with complex health conditions has failed to improve access to primary care or reduce hospitalizations, according to a study led by SFU health sciences professor Ruth Lavergne, in collaboration with UBC professor Kim McGrail.

The study is published in the Canadian Medical Association Journal.

“There is no evidence that the introduction of incentive payments to physicians changed access to primary care, kept patients out of hospital or saved money,” says Lavergne, who is new to SFU's Faculty of Health Sciences, arriving in July.

More than $240 million in incentive payments have been provided since the program was introduced through the General Practice Services Committee in 2007, a partnership between BC’s Ministry of Health and Doctors of BC (formerly the BC Medical Association).

The program’s goal was to encourage primary care physicians to provide care for patients with two or more chronic conditions such as diabetes or respiratory disease. Physicians were paid an extra $315 per year to care for complex patients.

Of the more than 155,000 eligible patients who saw primary care physicians in the study period, nearly 64 per cent had at least one incentive payment billed for their visit.

While the investment has improved physician compensation for caring for complex patients researchers say it has not led to measurable improvements in the outcomes they examined.

Lavergne says other strategies are needed to improve care for this group.