It is generally accepted that the method of payment to physicians affect their professional attitude and behaviour. Consequently, health policy makers manipulate payment system in an attempt to achieve optimal health care for their citizens such as improve accessibility, quality of care, patient’s satisfaction and cost containment. In Ontario, there are a wide range of mechanisms that are used to pay physicians for their services that are funded by both federal and provincial government. According to Canada Health Act annual report (2013), the majority of primary healthcare physicians are funded using the fee for service payment arrangement but of that majority, only less than 30% are compensated exclusively according the fee for service plan. The remaining physicians are funded using one of the following mixed compensation models:
1. Enhanced Fee-for-service: Family Health Groups (FHG), Comprehensive Care Model
2. Blended Capitation Models: Family Health Network(FHN) , Family Health Organization (FHO)
3. Blended Complement Model : Rural and Northern Physician Group Agreements (RNPGA)
4. Blended Salary Model: Community sponsor Family Health Team (FHT)
Each model presents different types of earning incentives for physicians to provide cost effective care which improves clinical outcome.
This paper will conduct a cost benefit analysis of the three underlying methods that are either used solely or blended together to pay physicians in Ontario. It will compare and contrast Fee for service, capitation, and salary model. This paper will explore the impact of these models on quality and quantity of the primary health care system.
Fee for Service
Fee for Service is the most common and also the most accused metho...
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...2012–2013 (130413). (2013). Retrieved from Majesty the Queen in Right of Canada website: http://www.hc-sc.gc.ca/hcs-sss/alt_formats/pdf/pubs/cha-ics/2013-cha-lcs-ar-ra-eng.pdf
Blomqvist A., Busby C., (2012). How to pay family doctors: Why “pay per patient” is better than fee for service. C.D. Howe Institute Commentary, Commentary 365.
Lischko A. (2011). Physician payment reform: A review and update of the models. Massachusetts medical society.
Xu, M & Yu, W. (2003). Physician payment options: A policy discussion for New Brunswick. University of New Brunswick Department of Health and wellness.
Chawla, M., Windak, A., Berman, P., & Kulis, M. (1997). Paying the Physician: Review of Different Methods. Data for Decision Making Project,Department of Population and International Health, Harvard School of Public Health, Boston, Massachussetts
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