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Bridging Silos: Moving to Integrated Health Care Provider Funding Models in Canada

 

HQO

Brief Description:

 Much recent attention in Canadian health care policy circles has been given to the emergence of integrated health care provider funding models in the United States and elsewhere, including bundled payments and Accountable Care Organizations. Under these models, single payments are issued to groups of health care organizations and providers around a patient’s complete treatment episode, or for a year of care. These models mark a sharp break from provinces’ current health care payment systems, which typically reimburse services from individual organizations or providers using a disconnected mix of global budgets and fee-for-service payment models. In theory, moving to integrated funding models should provide incentives for better coordinated, more efficient care by ensuring that all providers have “skin in the game” across the full patient journey.
 
In this session, we help policy makers make sense of the field of buzzwords such as bundled payments, global payments, episodes of care and Accountable Care Organizations. We survey the recent international experience with these models and review the emerging – but still limited – evidence on the impacts of these models. Closer to home, we examine Health Quality Ontario (HQO)’s recent work developing analyses around integrated episodes of care for high volume patient populations, combining linked administrative data and evidence-based best practice recommendations to examine regional variations in patient pathways, costs and outcomes. HQO’s work demonstrates the technical feasibility of developing episode-based analyses using Canadian data, with implications for policy and practice. Finally, we conclude with reflections from Canadian policy makers on the challenges, opportunities and ‘devils in the details’ of implementing new integrated funding models in the Canadian health care policy context.  

Presenter:

Erik Hellsten: Senior Specialist, Quality-Based Funding, Health Quality Ontario

Commentary:

Jillian Paul:  Acting Director, Health Quality Branch Ontario Ministry of Health and Long-Term Care

Who should Attend:

This presentation was by invitation only.

FIRESIDE CHAT:

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Download the Power Point Presentation (PDF 1.65MB)

Download the Podcast (51.8MB)

 

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Health Canadacihr logo1This initiative has been generously funded by grants from Health Canada and the Canadian Institutes of Health Research. The views expressed here do not necessarily reflect those of the funders.