title: The financial impact of team-based care on primary care.
abstract: Although team-based care can improve coronary heart disease (CHD) risk factors and is considered cost-effective from a healthcare system perspective, little is known about the financial impact of team-based primary care for secondary prevention of CHD. The purpose of this study was to define the impact of team-based care for CHD on utilization, costs, and revenue of a private primary care practice.
  
  
  
  Interrupted time series analysis.
  
  
  
  Between March 1, 2010, and March 31, 2013, we assisted a private medical practice, comprising 5 primary care clinic sites, to organize and deliver team-based care for patients with CHD. We used billing records and the registered nurse care manager's diary to calculate the cost of team-based care, differences in the average number of visits per patient, and revenue per patient before and after the implementation of team-based care.
  
  
  
  The net cost of team-based primary care was $291 per patient over the 1-year period of observation.
  
  
  
  The findings from this study are consistent with other economic analyses of team-based care and suggest that payment for care must be restructured if patients are expected to enjoy the benefits of team-based primary care.
authors.affiliation: HealthPartners Institute, 8170 33rd Ave South, Mail Stop 21110X, Bloomington, MN 55425. E-mail: thomas.e.kottke@healthpartners.com.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Kottke
authors.forename: Michael V
authors.initials: MV
authors.lastname: Maciosek
authors.forename: Jacquelyn A
authors.initials: JA
authors.lastname: Huebsch
authors.forename: Paul
authors.initials: P
authors.lastname: McGinnis
authors.forename: Jolleen M
authors.initials: JM
authors.lastname: Nichols
authors.forename: Emily D
authors.initials: ED
authors.lastname: Parker
authors.forename: Juliana O
authors.initials: JO
authors.lastname: Tillema
mesh_terms: D060866:Accountable Care Organizations / Q000191:economics; D015897:Comorbidity; D003327:Coronary Disease / Q000191:economics* / Q000517:prevention & control; D003365:Costs and Cost Analysis; D003920:Diabetes Mellitus / Q000191:economics* / Q000628:therapy; D004059:Diffusion of Innovation; D018588:Fee-for-Service Plans / Q000191:economics; D006801:Humans; D065186:Interrupted Time Series Analysis; D010348:Patient Care Team / Q000191:economics* / Q000458:organization & administration; D011320:Primary Health Care / Q000191:economics* / Q000458:organization & administration; D012307:Risk Factors; D055502:Secondary Prevention / Q000191:economics* / Q000379:methods / Q000458:organization & administration