Pay for Performance in Primary Healthcare

by Christopher Millett & Brian Hutchison | Sep 23, 2009

Session Resources

View the slides - PDF (885 KB)

Watch the video - Flash (48:55)

September 23, 2009
12:00 p.m. - 12:45 p.m. EDT
Call in English only

The concept of pay for performance in healthcare has sparked a growing interest and debate among health system managers, policy makers and healthcare providers within Canada and abroad. The notion that providers should be financially rewarded for the quality of the healthcare services they provide is both fashionable and controversial.

Key questions addressed in this Researcher on Call:

  1. What is pay for performance in primary healthcare?
    • "comprehensive" pay for performance - the U.K. Quality and Outcomes Framework
    • selective pay for performance - the Ontario example
  2. What does the evidence say?
    • quality of care
    • health outcomes
    • the patient experience
  3. Are there unintended consequences?
    • evidence, experience and misgivings
  4. What are the prerequisites for implementation?
  5. Does it deliver value for money?

Featured Speakers

Christopher Millett, M.Sc., M.Phil., FFPH, Ph.D., a 2008-09 Commonwealth Fund Harkness Fellow in Health Care Policy and Practice, is a consultant in public health at Imperial College.

Prior to this role, he held positions as a specialist trainee in public health for the London NHS Public Health Training Program, and as honorary research fellow in the Health Services Research Unit at University College London, School of Public Policy. Millett's research interests include access to preventative care, tobacco policy, and equity in chronic disease management programs. He has written over 30 peer-reviewed journal articles, with publications in PLoS Medicine, Journal of General Internal Medicine, Canadian Medical Association Journal, Tobacco Control, and the International Journal of Obesity. He holds a Ph.D. from Imperial College, London, master's degrees in health psychology and medicine from City University and University College London, respectively, and is a fellow of the U.K. Faculty of Public Health, Royal College of Physicians.

Brian Hutchison is a Professor Emeritus in the Departments of Family Medicine and Clinical Epidemiology and Biostatistics at McMaster University, Co-Chair of the Canadian Working Group for Primary Healthcare Improvement, President-elect of the Canadian Association for Health Services and Policy Research and Senior Advisor to the Quality Improvement and Innovation Partnership (QIIP).
He is past Director (2002-2005) of the McMaster University Centre for Health Economics and Policy Analysis (CHEPA) and served as founding Editor-in-Chief of Healthcare Policy from 2004-2009. Brian held a National Health Research Scholar award from Health Canada from 1994 to 1999. He was the 2004 recipient of the Health Services Research Advancement Award presented by the Canadian Health Services Research Foundation. Brian received a Lifetime Achievement Award in Family Medicine Research from the College of Family Physicians of Canada in 2008. His areas of research and policy interest include organization, funding and delivery of primary and community care, needs-based health care resource allocation and funding methods, provider payment methods, quality improvement and preventive care./p>

Readings of interest

Impact of Pay for Performance on Ethnic Disparities in Intermediate Outcomes for Diabetes: A Longitudinal Study

Ethnic Disparities in Blood Pressure Management in Patients With Hypertension After the Introduction of Pay for Performance

Effect of the quality and outcomes framework on diabetes care in the United Kingdom: retrospective cohort study

Pay for Performance in Primary Care: Proceed with Caution, Pitfalls Ahead

Documents from the 2009 EXTRA CEO Forum entitled Service-Based Funding and Paying for Performance: Experience, Evidence and Future Prospects

For more information, please contact roc-csa@chsrf.ca or 613-728-2238 ext. 221.