Production of physician services under fee‐for‐service and blended fee‐for‐service: Evidence from Ontario, Canada

B-Tier
Journal: Health Economics
Year: 2019
Volume: 28
Issue: 12
Pages: 1418-1434

Authors (10)

Nibene H. Somé (not in RePEc) Rose Anne Devlin (not in RePEc) Nirav Mehta (University of Western Ontario) Greg Zaric (not in RePEc) Lihua Li (not in RePEc) Salimah Shariff (not in RePEc) Bachir Belhadji (not in RePEc) Amardeep Thind (not in RePEc) Amit Garg (not in RePEc) Sisira Sarma (The University of Western Onta...)

Score contribution per author:

0.201 = (α=2.01 / 10 authors) × 1.0x B-tier

α: calibrated so average coauthorship-adjusted count equals average raw count

Abstract

We examine family physicians' responses to financial incentives for medical services in Ontario, Canada. We use administrative data covering 2003–2008, a period during which family physicians could choose between the traditional fee for service (FFS) and blended FFS known as the Family Health Group (FHG) model. Under FHG, FFS physicians are incentivized to provide comprehensive care and after‐hours services. A two‐stage estimation strategy teases out the impact of switching from FFS to FHG on service production. We account for the selection into FHG using a propensity score matching model, and then we use panel‐data regression models to account for observed and unobserved heterogeneity. Our results reveal that switching from FFS to FHG increases comprehensive care, after‐hours, and nonincentivized services by 3%, 15%, and 4% per annum. We also find that blended FFS physicians provide more services by working additional total days as well as the number of days during holidays and weekends. Our results are robust to a variety of specifications and alternative matching methods. We conclude that switching from FFS to blended FFS improves patients' access to after‐hours care, but the incentive to nudge service production at the intensive margin is somewhat limited.

Technical Details

RePEc Handle
repec:wly:hlthec:v:28:y:2019:i:12:p:1418-1434
Journal Field
Health
Author Count
10
Added to Database
2026-01-25