• Thomas F Feasby and Cindy Gerdes.
• Academic Affairs, Capital Health, Edmonton.
• Healthc Pap. 2006 Jan 1; 6 (4): 47-50; discussion 72-4.

AbstractPhysician reimbursement in Canada has been dominated by pay-for-volume which leads to high utilization. The concern is that this does not promote attention to quality issues that are known to affect health services. However, the evidence that pay-for-quality works is weak, despite the logic of the approach. Also, pay-for-quality methods that seem to work in primary care may not be appropriate in specialties such as surgery. Canada offers opportunities to assess the effect of pay-for-performance in several areas. Developing primary care networks are attractive locations to study the effect of pay-for-quality, perhaps even in a randomized trial. Specialized high-volume surgical programs, such as the Alberta arthroplasty pilot project, might be study of pay-for-participation, in a partnership of providers and sponsors.

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