Family Doctor Incentives: Getting Closer to the Sweet Spot

Most Canadian doctors are paid for each service that they provide. Such an approach is relatively simple to administer and enforce, and can, in principle, provide more access to care. On the downside, however, the model incents volume rather than quality of care.

While there are those who argue that governments could incent better health outcomes if a single-pay model were adopted—for example, using a pay-for-performance approach—others advocate a pay-per-patient model. But according to Canadian and international experience, the answer is not so simple. Each model has its pros and cons, and an appropriate context for applying it.

Rather than advocating one pay model over another, the better approach is to aim to get closer to the right blend for each setting.

This briefing is a primer on the principles that could guide policy-makers in getting closer to the best incentive blends that will improve health care outcomes.