Abstract
The financing, payment and organization of medical services are closely related. Canada's health care system is financed publicly, from tax revenue, and administered in each province by a single government payer. Although the chief method of payment to physicians is fee for service (FFS), the need to control costs and organize practice more efficiently has led to increased interest in FFS variants, such as capping payments at a certain level or fixing a budget, and alternative payment methods such as capitation-based payment, salary and combinations of these methods. Although solo practice is reportedly still the chief method of practice organization, it is being steadily replaced by arrangements in which physicians share expenses or calls, and by formal partnerships and group and team practices. As medical practice in Canada continues to shift from solo to group and team practice alternative payment methods that facilitate these models will become more common.
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- Glaser W. A. The politics of paying American physicians. Health Aff (Millwood) 1989 Fall;8(3):129–146. doi: 10.1377/hlthaff.8.3.129. [DOI] [PubMed] [Google Scholar]
- Hsiao W. C., Braun P., Dunn D., Becker E. R., DeNicola M., Ketcham T. R. Results and policy implications of the resource-based relative-value study. N Engl J Med. 1988 Sep 29;319(13):881–888. doi: 10.1056/NEJM198809293191330. [DOI] [PubMed] [Google Scholar]
- Lee S. S., Butler L. M. The three-layered cake--a plan for physician compensation. N Engl J Med. 1974 Aug 1;291(5):253–256. doi: 10.1056/NEJM197408012910512. [DOI] [PubMed] [Google Scholar]
- Lomas J., Fooks C., Rice T., Labelle R. J. Paying physicians in Canada: minding our Ps and Qs. Health Aff (Millwood) 1989 Spring;8(1):80–102. doi: 10.1377/hlthaff.8.1.80. [DOI] [PubMed] [Google Scholar]
- Renaud M., Beauchemin J., Lalonde C., Poirier H., Berthiaume S. Practice settings and prescribing profiles: the simulation of tension headaches to general practitioners working in different practice settings in the Montreal area. Am J Public Health. 1980 Oct;70(10):1068–1073. doi: 10.2105/ajph.70.10.1068. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vayda E., Williams A. P., Stevenson H. M., Pierre K. D., Burke M., Barnsley J. Characteristics of established group practices in Ontario. Healthc Manage Forum. 1989 Winter;2(4):17–23. doi: 10.1016/S0840-4704(10)61407-X. [DOI] [PubMed] [Google Scholar]
- Welch W. P., Hillman A. L., Pauly M. V. Toward new typologies for HMOs. Milbank Q. 1990;68(2):221–243. [PubMed] [Google Scholar]
- Williams A. P., Vayda E., Stevenson H. M., Burke M., Pierre K. D. A typology of medical practice organization in Canada. Data from a national survey of physicians. Med Care. 1990 Nov;28(11):995–1004. doi: 10.1097/00005650-199011000-00002. [DOI] [PubMed] [Google Scholar]