Which funding methods best facilitate system-wide integration? This follow-up report to our Tools for Change Symposium in April 2010 summarizes the case studies, literature review, background papers and discussion on how funding incentives and levers can be used to integrate patient care in Ontario.
While recognizing that leadership and culture are key levers, the report focuses on payment systems and their intentional or unintentional impacts on care.
- Use funding mechanisms to support strategic priorities; system-wide impact matters.
- Move beyond provider-based funding models; organizational span matters.
- Include primary care in system planning.
- Blunt the effect of fee-for-service payment models.
- Use non-financial incentives to appeal to excellence.
- Build a culture of quality; financial incentives alone can’t change culture.
- Make accountability and performance reporting play a bigger role; governments must clearly articulate goals and policy objectives.
- Maximize good features and remove perverse incentives; apply continuous improvement to funding reform.