The Impact Of Physician Remunerations On Patient Outcomes And Quality Of Care

The policy issue that I have selected to discuss herein is the pay-for-performance payment model. I feel that this impacts a large number of our population and changes in this regard should be made. This type of payment model aims to use reimbursement to incentivize providers to deliver high quality services. Pay-for-performance model steps away from the traditional manner of reimbursement of fee-for-service, in which providers receive payment on the basis of frequency or volume of the services they provide regardless of outcomes. In contrast,

Health care expenditure accounted for an estimated 11% (214.9 billion) of Canada’s GDP in 2014 (CIHI, 2014). Canada boasts a universal, cost-effective and fair health care system to its citizens (Picard, 2010). However, despite great claims and large expenses incurred Canada’s health care system has been reported inefficient in it’s delivery to the population (Davis, Schoen, & Stremikis, 2010; Picard, 2010). As inconsistencies exist in health care delivery across the country, choosing priorities for the health of the Canadian people becomes of vital importance. In Ontario, progress toward a better health care system has been stated to be moving forward by putting the needs of the “patient’s first” (Ministry of Health and Long-Term Care [MOHLTC], 2015). This policy brief will give a background of health care issues in Canada related to Ontario. Three evidence-based priorities will be suggested for Ontario’s health policy agenda for the next three to five years. Furthermore, through a critical analysis of these issues a recommendation of the top priority issue for the agenda will be presented.

First implemented in 1985 by Aetna (previously U.S. Healthcare), P4P programs were used to reward top performers and improve outcomes (Bruno, 2012). The incentives were meant to improve the quality of patient care by basing incentives on patient outcomes. Conversely, fee-for-service reimbursements are based on the treatments and set limits on the amount reimbursed for services. Because of these limits, incentives for use of pharmaceuticals and non-invasive procedures can impact how physicians practice.

This paper will compare the healthcare service and healthcare status between Canada and the United States. Canada and the United States have a totally different healthcare system. Many people argued that the United States healthcare system needs some upgrading, while, some people admire Canada’s healthcare system due to the fact that Canada’s healthcare does more for less. Research has shown that Canada spends less of its’ GDP on it’s healthcare yet performs better than the United States.

This paper will discuss the Canadian healthcare system compared to the United States healthcare system. Although they’re close in proximity, these two nations have very different health care systems. Each healthcare system has its own difficulties, and is currently trying to find ways to improve. Canada currently uses the Universal Health Care system; which provides healthcare coverage to all Canadian citizens (Canadian Health Care, 2007). The services are executed on both a territorial and provincial basis, by staying within the guidelines that have been enforced by the federal government (Canadian Health Care, 2007).

Financial Incentives for Primary care: Comparison costs of practices using PCMH model to those that do not and achieved savings (by reducing hospital admissions and unnecessary tests, they can get half $ back. The catch is that they only get the $ if they’ve met a whole checklist of quality measures for preventive care, chronic disease management and so on. Primary Care is rewarded for efficiency without sacrificing quality. Half of savings goes to Geisinger’s own health plan that funds extra services and creates medical homes. The health plan earned 2.5 times its R.O.I. back in the first year.

Under Canada’s healthcare system, citizens are provided with primary care and medical treatments, as well as easy access to hospitals, clinics, and any other additional medical services. Regardless of annual income, this system allows all Canadian citizens access to medical services without immediate pay. Canada is fortunate to have a free healthcare plan since this necessity comes at a substantial expense for people living in the United States of America. For instance, the Commonwealth Fund's Health Insurance Survey mentions that “80 million people, around 43% of America's working-age adults, did not go to the doctor or access other medical services because of the cost” (Luhby). Evidently, Canada’s healthcare system is notorious in supporting the demands of the population, and creating a healthy and happy society at a manageable cost.

Most Canadians are very proud of their health care because it provides citizens universal coverage on the basis of need. However, in the recent decade, Canadians have observed obvious deterioration in the quality of the system in regards to waiting times, availability of the best technology, and adequate numbers of doctors and nurses. The apparent decline within the system has made many Canadians more open to a variety of options than they were a decade ago, provided that the core elements of the system are preserved and that these changes lead to tangible improvements in quality without damaging accessibility. In the article Canadians’ Thoughts on Their Health Care System: Preserving the Canadian Model through Innovation by Matthew Mendelsohn, he stated that 1/3 of Canadians support the two-tiered healthcare system, which offers its citizens an option of public or private health care. Canada will benefit from a two-tier health care system because it will shorten waiting times, other countries with two-tier healthcare have proven to be successful, will encourage doctors to return and stay in Canada, introduce competition and give citizens freedom to choose.

Four compensation models are laid out by the Bangor Family Physician case study. These models include: (1) revenue model; (2) net income model; (3) base salary plus

The purpose of this paper is to compare the Canadian and the United States health care system. the first part of the paper will focus on describing each country health care system. The second part will focus on analyzing, evaluating and comparing these two countries system efficiency and benefits. The last part, is an overview of the recent policies changes and its effect (positive and negative) on each country citizens and proposed future reforms for better coverage in these countries.

There is a growing trend in the United States called pay-for-performance. Pay-for-performance is a system that is used where providers are compensated by payers for meeting certain pre-established measures for quality and efficiency (What is Pay-for-Performance, n.a.). We are going to be discussing what pay-for-performance is. There are different aspects of pay-for-performance which include; the effects of reimbursement by this approach, the impact cost reductions has on quality and efficiency of health care, the affects to the providers and patients, and the effects on the future of health care.

In this paper, there will be a comparative analysis to the United States (U.S.) healthcare system and Canadians healthcare system highlighting the advantages and disadvantages of both.

Canada’s health care system “can be described as a publicly-funded, privately-provided, universal, comprehensive, affordable, single-payer, provincially administered national health care system” (Bernard, 1992, p.103). Health care in Canada is provincial responsibility, with the Canada Health act being a federal legislation (Bernard, 1992, p. 102). Federal budget cuts, has caused various problems within Medicare such as increased waiting times and lack of new technology. Another problem with Medicare is that The Canada Heath Act does not cover expenditures for prescriptions drugs. All these issue has caused individuals to suggest making Medicare privatized. Although, Canada’s health care system consists of shortcomings, our universal

More specifically it argues that a payment method based on salary will reduce physicians’ motivation to provide quality care to their patients (Grignon et al, 2002). Against this argument, I want to raise three points. Firstly, the blended salary model has very good incentive payments for priority services such as palliative care and preventative care (Hutchson & Glazier, 2013). Secondly, despite being a salary based model, the pay is still very high paying. Doctors will be earning over 100,000 dollars of base salary if the inter-professional team they are a part of have a roster size of a little over 900 patients (Guide to Physician Compensation, 2009). This translates to roughly 28 hours of work per week (Guide to Physician Compensation, 2009). Of course I do not deny that fee-for-service physicians can easily earn more, but blended salary model is by no means a poor man’s wage. All in all, it comes down to personal ethics. Perhaps some physicians are more concerned about profiting than actually doing their

Stanowski, A. C., Simpson, K., & White, A. (2015). Pay for Performance: Are Hospitals Becoming More Efficient in Improving Their Patient Experience?. Journal Of Healthcare Management, 60(4), 268-284 17p.