Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
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<strong>Health</strong> systems in transition <strong>Canada</strong> 79<br />
addition, some ministries have also begun to implement pay <strong>for</strong> per<strong>for</strong>mance<br />
incentives, group-based profit sharing and fundholding systems (Léger, 2011).<br />
However, these “alternative payment systems”, so-called in <strong>Canada</strong> because<br />
they pose an alternative to fee-<strong>for</strong>-service systems, should not be seen as<br />
synonymous with primary care re<strong>for</strong>m (Hutchison et al., 2011). In a number of<br />
cases, alternative payment is being used to pursue objectives that have little to<br />
do with altering existing <strong>for</strong>ms of primary care. In some provinces <strong>for</strong> example,<br />
alternative payments are concentrated in specialties such as cancer care and<br />
psychiatry, while in other provinces, alternative payments contracts are<br />
provided <strong>for</strong> after-hours coverage of patients in primary care settings (Glazier<br />
et al., 2009; CIHI, 2010c).