Enhanced Fee-for-Service Model and Access to Physician Services: Evidence from Family Health Groups in Ontario
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 improving access to physician services.
|Date of creation:||Apr 2010|
|Publication status:||published in: Journal of Health Economics, 2011, 30 (1), 99-111|
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- McGuire, Thomas G., 2000. "Physician agency," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 9, pages 461-536 Elsevier.
- 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.
- Thomas F. Crossley & Jeremiah Hurley & Sung-Hee Jeon, 2009. "Physician labour supply in Canada: a cohort analysis," Health Economics, John Wiley & Sons, Ltd., vol. 18(4), pages 437-456.
- Thomas F. Crossley, Jeremiah Hurley, and Sung-Hee Jeon, 2006. "Physician Labour Supply in Canada: a Cohort Analysis," Department of Economics Working Papers 2006-02, McMaster University.
- Thomas F. Crossley & Jeremiah Hurley & Sung-Hee Jeon, 2007. "Physician Labour Supply in Canada: a Cohort Analysis," Centre for Health Economics and Policy Analysis Working Paper Series 2006-04, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
- Thomas F. Crossley & Jeremiah Hurley & Sung-Hee Jeon, 2006. "Physician Labour Supply in Canada: a Cohort Analysis," Quantitative Studies in Economics and Population Research Reports 410, McMaster University.
- Ming Tai-Seale & Thomas H. Rice & Sally C. Stearns, 1998. "Volume responses to medicare payment reductions with multiple payers: a test of the McGuire-Pauly model," Health Economics, John Wiley & Sons, Ltd., vol. 7(3), pages 199-219.
- Jasmin Kantarevic & Boris Kralj & Darrel Weinkauf, 2008. "Income effects and physician labour supply: evidence from the threshold system in Ontario," Canadian Journal of Economics, Canadian Economics Association, vol. 41(4), pages 1262-1284, November.
- 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.
- Yip, Winnie C., 1998. "Physician response to Medicare fee reductions: changes in the volume of coronary artery bypass graft (CABG) surgeries in the Medicare and private sectors," Journal of Health Economics, Elsevier, vol. 17(6), pages 675-699, December.
- 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.
- Thomas G. McGuire & Mark V. Pauly, 1991. "Physician Response to Fee Changes with Multiple Payers," Papers 0015, Boston University - Industry Studies Programme.
- Rizzo, John A. & Blumenthal, David, 1994. "Physician labor supply: Do income effects matter?," Journal of Health Economics, Elsevier, vol. 13(4), pages 433-453.
- Edwin Leuven & Barbara Sianesi, 2003. "PSMATCH2: Stata module to perform full Mahalanobis and propensity score matching, common support graphing, and covariate imbalance testing," Statistical Software Components S432001, Boston College Department of Economics, revised 19 Jan 2015.
- 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.
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