{"id":3139,"date":"2020-08-19T00:00:00","date_gmt":"2020-08-19T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/stirring-the-pot-switching-from-blended-fee%e2%80%90for%e2%80%90service-to-blended-capitation-models-of-physician-remuneration\/"},"modified":"2023-06-14T19:22:00","modified_gmt":"2023-06-14T23:22:00","slug":"stirring-the-pot-switching-from-blended-fee%e2%80%90for%e2%80%90service-to-blended-capitation-models-of-physician-remuneration","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/stirring-the-pot-switching-from-blended-fee%e2%80%90for%e2%80%90service-to-blended-capitation-models-of-physician-remuneration\/","title":{"rendered":"Stirring the pot: switching from blended fee\u2010for\u2010service to blended capitation models of physician remuneration"},"content":{"rendered":"<p>In Canada&apos;s most populous province, Ontario, family physicians may choose between the blended fee&#x2010;for&#x2010;service (Family Health Group [FHG]) and blended capitation (Family Health Organization [FHO] payment models). Both models incentivize physicians to provide after&#x2010;hours (AH) and comprehensive care, but FHO physicians receive a capitation payment per enrolled patient adjusted for age and sex, plus a reduced fee&#x2010;for&#x2010;service while FHG physicians are paid by fee&#x2010;for&#x2010;service. We develop a theoretical model of physician labor supply with multitasking to predict their behavior under FHG and FHO, and estimable equations are derived to test the predictions empirically. Using health administrative data from 2006 to 2014 and a two&#x2010;stage estimation strategy, we study the impact of switching from FHG to FHO on the production of a capitated basket of services, after&#x2010;hours services and nonincentivized services. Our results reveal that switching from the FHG to FHO reduces the production of capitated services to enrolled patients and services to nonenrolled patients by 15% and 5% per annum and increases the production of after&#x2010;hours and nonincentivized services by 8% and 15% per annum.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In Canada&apos;s most populous province, Ontario, family physicians may choose between the blended fee&#x2010;for&#x2010;service (Family Health Group [FHG]) and blended capitation (Family Health Organization [FHO] payment models). Both models incentivize physicians to provide after&#x2010;hours (AH) and comprehensive care, but FHO physicians receive a capitation payment per enrolled patient adjusted for age and sex, plus a [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-3139","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Som&#xe9; NH, Devlin RA, Mehta N, Zaric GS, Sarma S. <em>Health Econ<\/em>. 2020; 29(11):1435-55. Epub 2020 Aug 19.","source_url":"https:\/\/doi.org\/10.1002\/hec.4145","ices_scientist":[1371,13133],"site":[6739],"research_program":[],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"D0804640-4781-489D-9443-10FF1BECD99E","sitecore_item_name":"Stirring-the-pot-switching-from-blended-fee-for-service-to-blended-capitation-models","sitecore_field_values":"{\n  \"Title\": \"Stirring the pot: switching from blended fee\u2010for\u2010service to blended capitation models of physician remuneration\",\n  \"Short title\": \"Stirring the pot: switching from\",\n  \"Summary\": \"We study the impact of switching from Family Health Group to Family Health Organization on the production of a capitated basket of services, after\u2010hours services and nonincentivized services.rn\",\n  \"Citation\": \"<p>Som&eacute; NH, Devlin RA, Mehta N, Zaric GS, Sarma S. <em>Health Econ<\/em>. 2020; 29(11):1435-55. Epub 2020 Aug 19. DOI: <a href=\"https:\/\/doi.org\/10.1002\/hec.4145\" title=\"opens external link\">https:\/\/doi.org\/10.1002\/hec.4145<\/a><\/p>\",\n  \"Abstract\": \"<p>In Canada's most populous province, Ontario, family physicians may choose between the blended fee\u2010for\u2010service (Family Health Group [FHG]) and blended capitation (Family Health Organization [FHO] payment models). Both models incentivize physicians to provide after\u2010hours (AH) and comprehensive care, but FHO physicians receive a capitation payment per enrolled patient adjusted for age and sex, plus a reduced fee\u2010for\u2010service while FHG physicians are paid by fee\u2010for\u2010service. We develop a theoretical model of physician labor supply with multitasking to predict their behavior under FHG and FHO, and estimable equations are derived to test the predictions empirically. Using health administrative data from 2006 to 2014 and a two\u2010stage estimation strategy, we study the impact of switching from FHG to FHO on the production of a capitated basket of services, after\u2010hours services and nonincentivized services. Our results reveal that switching from the FHG to FHO reduces the production of capitated services to enrolled patients and services to nonenrolled patients by 15% and 5% per annum and increases the production of after\u2010hours and nonincentivized services by 8% and 15% per annum.<\/p>\",\n  \"Research Programs\": \"{5B1AF319-EC9B-4BF0-A9CD-D066ABE49D71}\",\n  \"ICES Locations\": \"{3B4AF7E8-6835-410B-AEB8-360A79CA0ED8}\",\n  \"ICES Scientists\": \"{1B85818F-7E73-43A2-A470-9AE260D05CC4}|{687A9751-6E5B-411B-9CE6-725BBC04A308}\",\n  \"Posted Date\": \"20200819T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2020\/August\/Stirring-the-pot-switching-from-blended-fee-for-service-to-blended-capitation-models"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Stirring the pot: switching from blended 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