Understanding, improving and aligning financial incentives in the Montreal region: Devising innovative strategies to increase volume and eliminate inefficiency

The Challenge: Maximizing available financial resources

Regional health and social services agencies in Quebec are responsible for coordinating the services in their region, allocating funding to institutions and ensuring efficient management. Agencies report to the Ministère de la santé et des services sociaux (MSSS). Agence de la santé et des services sociaux de Montréal (ASSSM) is responsible for allocating an annual budget of about $6 billion to 45 public and 26 private institutions and private healthcare facilities in the Montreal region.

In the current economic context, health systems are asking whether existing approaches to funding health and social services maximize the value of current spending. Health and social service providers within the catchment of ASSSM are advocating for additional funding to cover wage inflation, additional equipment, and expanding services to an aging and growing population.

The Collaboration: Making the most of the global budget

In 2012, ASSSM partnered with the Canadian Foundation for Healthcare Improvement (at the time called the Canadian Health Services Research Foundation) to research how incentives could best be utilized in meeting the challenge of ensuring that the global budget they receive from MSSS is allocated in a way that makes the most of every dollar.

The Result: Reports call for balance and alignment

Two comprehensive reports have emerged from this partnership:

The research, led by Jason Sutherland of the University of British Columbia’s Centre for Health Services and Policy Research, outlines the policy options available to ASSSM. It considers the need to balance improving access/increasing volume, controlling expenditure growth, maintaining quality, and short- and long-term ability to adapt to changes in funding methods (report 1). It also identifies the strengths and weaknesses of current funding approaches in Quebec, presents an analysis of funding flows within the region and makes a series of recommendations for better alignment of financial incentives with the objectives of ASSSM (report 2).

The Impact: Evidence-informed funding reform

The information and evidence that the two reports contain will inform ASSSM’s decision-making about funding and resource allocation within the region.

To learn more about this project, email us at info@cfhi-fcass.ca