RISQy Business (Relationships, Incentives, Supports, and Quality): Evolution of the British Columbia Model of Primary Care (Patient-Centered Medical Home)

MacCarthy, Dan; Hollander, Marcus J.

doi:10.7812/tpp/13-083

Cited by 8 publications

(12 citation statements)

References 16 publications

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“…(For more details about how primary care is delivered in BC, see the article by MacCarthy and Hollander. 1 ) In accordance with the Canadian Constitution, the provision of health care services is a provincial responsibility. The federal government collects both federal and provincial taxes.…”

Section: Funding Model For Primary Care In British Columbiamentioning

confidence: 99%

“…There is a complex set of rules regarding copayments for other services, such as drugs, long-term care, and allied health services. 1 In Fiscal Year 2010-2011, 49.8% of GPs in BC worked in solo practices and 34.8% worked in small group practices of 2 to 4 GPs. Conceptually, a general practice is very similar to the US patientcentered medical home.…”

Section: Funding Model For Primary Care In British Columbiamentioning

confidence: 99%

“…Conceptually, a general practice is very similar to the US patientcentered medical home. 1 Typically, one service is provided during one visit to a GP, although if a GP provides a service and a procedure during a single visit, s/he can bill for two activities. This allows GPs to care for a range of patients, including those needing complex care.…”

Section: Funding Model For Primary Care In British Columbiamentioning

confidence: 99%

“…In response to government proposals, a GP representative responded with the question "Why don't you just pay us for what you want us to do?" 1 This led to the formation of the General Practice Services Committee (GPSC), a joint committee of the BC Ministry of Health, the BC Medical Association (now Doctors of BC), and the Society of General Practitioners of BC.…”

Section: Funding Model For Primary Care In British Columbiamentioning

confidence: 99%

“…This solution is what the GPs believed they actually needed to provide enhanced care to their patients (eg, developing care plans and taking more time), particularly to those patients with chronic or complex conditions. 1 The incentive payments were initially implemented for GPs to provide enhanced, guidelines-based care to patients with diabetes and congestive heart failure (CHF) in 2003. Over time, other chronic conditions were added.…”

Section: Original Research and Contributionsmentioning

confidence: 99%

See 4 more Smart Citations

Incentive-Based Primary Care: Cost and Utilization Analysis

Hollander¹,

Kadlec²

2015

TPJ

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Section: Funding Model For Primary Care In British Columbiamentioning

confidence: 99%

Section: Funding Model For Primary Care In British Columbiamentioning

confidence: 99%

Section: Funding Model For Primary Care In British Columbiamentioning

confidence: 99%

Section: Funding Model For Primary Care In British Columbiamentioning

confidence: 99%

Section: Original Research and Contributionsmentioning

confidence: 99%

See 3 more Smart Citations

Incentive-Based Primary Care: Cost and Utilization Analysis

Hollander¹,

Kadlec²

2015

TPJ

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Assessing the Effectiveness of Policies to Reduce Diabetes Hospitalizations Before and After the Reforms of Physician Payment and Primary Care Organization in British Columbia and Alberta

Laberge

Koné

2016

Canadian Journal of Diabetes

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Learning from health system reform trajectories in seven Canadian provinces

Usher

Denis

Préval

et al. 2020

HEPL

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In publicly funded health systems, reform efforts have proliferated to adapt to increasingly complex demands. In Canada, prior research (Lazar et al., 2013, Paradigm Freeze: Why is it so Hard to Reform Health Care in Canada?, McGill-Queen's Press) found that reforms at the end of the 20th century failed to change the fundamentals of the Canadian system based on physician independence and assured universal coverage only for medical and hospital services. This paper focuses on reforms since the turn of the millennium to explore the transformative capacities developed in seven provinces within this system architecture. Longitudinal case studies, based on scientific and grey literature, and interviews with key informants, trace the patterns of reform in each province and reveal five objectives that, to varying degrees, preoccupied reformers: (1) address chronic disease, (2) align health system actors with provincial objectives, (3) shift from hospital to community-based care, (4) integrate physicians, and (5) develop improvement capacities. The range of strategies adopted to achieve these objectives in different provinces is compared to identify emerging pathways of reform and extract lessons for future reformers. We find significant cross-learning between provinces, but also note an emergent dimension to reforms, where multiple strategies aggregate through time to create unique patterns, presenting their own set of possibilities and limitations for the future.

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RISQy Business (Relationships, Incentives, Supports, and Quality): Evolution of the British Columbia Model of Primary Care (Patient-Centered Medical Home)

Cited by 8 publications

References 16 publications

Incentive-Based Primary Care: Cost and Utilization Analysis

Incentive-Based Primary Care: Cost and Utilization Analysis

Assessing the Effectiveness of Policies to Reduce Diabetes Hospitalizations Before and After the Reforms of Physician Payment and Primary Care Organization in British Columbia and Alberta

Learning from health system reform trajectories in seven Canadian provinces

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