Association of Specialist Physician Payment Model With Visit Frequency, Quality, and Costs of Care for People With Chronic Disease

Question  Is a specialist physician payment model associated with visit frequency, quality of care, and costs for people with chronic disease?

Findings  In this population-based cohort study that included a propensity-score matched cohort of 31?898 adults with diabetes or chronic kidney disease seen by 489 physicians, there was no statistical evidence of a difference in follow-up outpatient visit rates, quality, and costs between patients seeing salaried and fee-for-services physicians. The median association of physician clustering and the outcomes was greater than the association with the physician payment model.

Meaning  Specialist physician payment does not appear to be associated with variation in use of chronic disease care, quality, and costs; however, these findings suggest large variation in outcomes between physicians.