Estonia faces an aging population with an increasing burden of non-communicable diseases, such as hypertension, diabetes, and depression. From a physician¡¯s perspective, care for patients at risk for these diseases can be quite intensive, as they require both preventive care and extensive follow-up care after diagnosis, as well as coordination among primary care physicians and specialists. Financial incentives for primary care physicians have failed to spur them to take-up quality enhancement programs, as have policies that have changed the role of primary care physicians vis a vis specialists. Using claims data from the Estonian Health Insurance Fund, this evaluation tests the impacts of strategies to increase physicians¡¯ adoption of a quality enhancement program for high-risk patients, including a week-long mentoring visit from a peer-doctor with a structured curriculum, weekly one-hour coaching sessions, and a combination of the mentoring and coaching sessions.
