Valuing Quality: Patient-focused Funding in British Columbia

The April 2010 BC government announcement of $250 million for patient-focused funding (PFF) marks an important development. The BC government has signaled that it will embark on significant changes to better manage health care costs. The PFF initiative will shift away from providing global budgets to hospitals and move toward a system that provides incentives to manage health care expenditures. 

The Doctors of BC supports the BC government’s interest in having greater financial accountability in the current global budget management. In principle, it also supports the use of financial incentives to manage health care costs better. But, the Doctors of BC firmly believes that a great deal of work needs to be done to ensure that there is a shared understanding of how new funding models will function, and that patient safety and quality of care must be included as a key measurement criteria in any incentive program.

The Doctors of BC believes it is timely to examine the opportunities and limitations that these funding models present. This paper reviews the international and Canadian experience with PFF models and provides an assessment of what British Columbia can learn from these situations.

The Doctors of BC offers 10 recommendations on the design, implementation, and evaluation of PFF. These recommendations were developed after a thorough review of the best available research and a consultative process with health care stakeholders, including representatives of health authorities, patients, and the provincial government:

• PFF programs must be designed to improve the timeliness, safety, and health outcomes of patient care within a cost-certain environment. Cost reduction in isolation is unacceptable.
• Physicians and other health care providers must be involved in the development of BC’s PFF program. This can best be facilitated by the creation of a working group by the BC Health Services Purchasing Organization to ensure the design, implementation, and evaluation of PFF programs. Membership must include representatives from the Ministry of Health Services, the health authorities, the BCMA, and appropriate allied health professionals.
• PFF programs must be rigorously evaluated and monitored for their impact on patient care, access, and costs through an ongoing and transparent process.
• A phased, flexible approach should be used to design and implement PFF that responds to providers’ performance and the evolution of a program’s scope and goals.

For the full policy paper, please see “Valuing Quality: Patient-focused Funding in British Columbia”.