Kevin Eliason*
There is a consensus that payment for administrative services does not go far enough to support the provision of high-value care. Our Enterprise, a Pittsburgh-based payer-supplier corporation, created an endocrinologists' elective compensation model. With our arrangement, endocrinologists' jobs are continuously shifting away from clinical responsibilities and toward a more collaborative role with their key consideration partners. Given that the majority of diabetic patients are managed under primary care, this change enables endocrinologists to assist primary care physicians (PCPs) in managing patients with diabetes and other endocrinerelated illnesses while reducing the frequency of usual in-office references to endocrinology. Despite the unanticipated changes that COVID welcomed, during the first nine months of the pay model, we observed its impact on care delivery as well as the relationship between participating trained professionals and PCPs. Diabetes-explicit quality measurements have improved, according to practice- and supplier-level quality information. For diabetes executives, 16 out of 54 objective practises obtained NCQA recognition in a single year. A fulfilment score of > 90% was reported by a total of 88% of participating PCPs. Finally, our model suggests using guarantees in place of administration fees with a chance to reduce costs and improve the quality of care.
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