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Enhanced fee-for-service model and physician productivity: Evidence from Family Health Groups in Ontario

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Author Info

  • Kantarevic, Jasmin
  • Kralj, Boris
  • Weinkauf, Darrel

Abstract

We study an enhanced fee-for-service model for primary care physicians in the Family Health Groups (FHG) in Ontario, Canada. In contrast to the traditional fee-for-service (FFS) model, the FHG model includes targeted fee increases, extended hours, performance-based initiatives, and patient enrolment. Using a long panel of claims data, we find that the FHG model significantly increases physician productivity relative to the FFS model, as measured by the number of services, patient visits, and distinct patients seen. We also find that the FHG physicians have lower referral rates and treat slightly more complex patients than the comparable FFS physicians. These results suggest that the FHG model offers a promising alternative to the FFS model for increasing physician productivity.

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Bibliographic Info

Article provided by Elsevier in its journal Journal of Health Economics.

Volume (Year): 30 (2011)
Issue (Month): 1 (January)
Pages: 99-111

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Handle: RePEc:eee:jhecon:v:30:y:2011:i:1:p:99-111

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Web page: http://www.elsevier.com/locate/inca/505560

Related research

Keywords: Physician productivity Remuneration Primary care Family Health Groups Canada;

References

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  1. Thomas F. Crossley & Jeremiah Hurley & Sung-Hee Jeon, 2006. "Physician Labour Supply in Canada: a Cohort Analysis," Social and Economic Dimensions of an Aging Population Research Papers 162, McMaster University.
  2. Devlin, Rose Anne & Sarma, Sisira, 2008. "Do physician remuneration schemes matter? The case of Canadian family physicians," Journal of Health Economics, Elsevier, vol. 27(5), pages 1168-1181, September.
  3. Thomas G. McGuire & Mark V. Pauly, 1991. "Physician Response to Fee Changes with Multiple Payers," Papers 0015, Boston University - Industry Studies Programme.
  4. Matt Sutton & Ross Elder & Bruce Guthrie & Graham Watt, 2010. "Record rewards: the effects of targeted quality incentives on the recording of risk factors by primary care providers," Health Economics, John Wiley & Sons, Ltd., vol. 19(1), pages 1-13.
  5. Rajeev H. Dehejia & Sadek Wahba, 1998. "Propensity Score Matching Methods for Non-experimental Causal Studies," NBER Working Papers 6829, National Bureau of Economic Research, Inc.
  6. Jeffrey M. Wooldridge, 2005. "Fixed-Effects and Related Estimators for Correlated Random-Coefficient and Treatment-Effect Panel Data Models," The Review of Economics and Statistics, MIT Press, vol. 87(2), pages 385-390, May.
  7. McGuire, Thomas G. & Pauly, Mark V., 1991. "Physician response to fee changes with multiple payers," Journal of Health Economics, Elsevier, vol. 10(4), pages 385-410.
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Citations

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Cited by:
  1. Jasmin Kantarevic & Boris Kralj, 2013. "Link Between Pay For Performance Incentives And Physician Payment Mechanisms: Evidence From The Diabetes Management Incentive In Ontario," Health Economics, John Wiley & Sons, Ltd., vol. 22(12), pages 1417-1439, December.
  2. Coyle, Natalie & Strumpf, Erin & Fiset-Laniel, Julie & Tousignant, Pierre & Roy, Yves, 2014. "Characteristics of physicians and patients who join team-based primary care practices: Evidence from Quebec's Family Medicine Groups," Health Policy, Elsevier, vol. 116(2), pages 264-272.
  3. Kantarevic, Jasmin & Kralj, Boris, 2011. "Quality and Quantity in Primary Care Mixed Payment Models: Evidence from Family Health Organizations in Ontario," IZA Discussion Papers 5762, Institute for the Study of Labor (IZA).

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