Physician Assistants and Nurse Practitioners Perform Effective Roles on Teams Caring for Medicare Patients with Diabetes

摘要

Redesigning healthcare systems to deliver team-based care is considered important to improving care for chronically ill patients. Including physician assistants and/or nurse practitioners on primary care teams is one approach to the patient-centered medical home. However, understanding of the impact of team structure on outcomes is limited. Using Medicare claims and electronic health record data from a large physician group, we compared multiple patient outcomes for older patients with diabetes between patient panels receiving physician only care and panels where primary care physician assistantsurse practitioners served in different roles. Specific roles were associated with different quality of diabetes care and health service utilization patterns and no role was best for all outcomes. Findings suggest multiple potential approaches to implementing roles on primary care teams exist; however, local factors, including the characteristics of the patients served and prioritization of goals may be important considerations when implementing roles.