Abstract
Objectives: To consider the most common primary care reimbursement structures, to identify incentives inherent in each, and to discuss how each could be used to encourage a shared-care approach to treating mental disorders at the primary care level. Method: Three major financial reimbursement models - fee-for-service, capitation, and blended payment mechanisms - are examined. Each is considered in terms of its risk-sharing elements and the consequent incentives. We offer several scenarios to illustrate how the shared-care practice model might be encouraged under each financing mechanism. Results: The current fee-for-service system does not encourage shared care. For wide adoption of the shared-care practice model, there must be a change in the reimbursement system's incentives. While none of the financing mechanisms offers a perfect solution, each has potential. Each, however, must be carefully tailored to its environment. Conclusions: Financial considerations are just one aspect to achieving shared care. Nevertheless, in designing a system to encourage collaborative, coordinated care for those suffering from mental illness, decision makers should be wary of creating or maintaining obstacles (financial or otherwise) to provision of accessible, high-quality care.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 488-495 |
| Number of pages | 8 |
| Journal | Canadian Journal of Psychiatry |
| Volume | 46 |
| Issue number | 6 |
| State | Published - 2001 |
| Externally published | Yes |
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Keywords
- Blended payments
- Capitation
- Fee-for-service
- Financial incentives
- Shared mental health care
ASJC Scopus subject areas
- Psychiatry and Mental health
Cite this
Using financial incentives to promote shared mental health care. / Dewa, Carolyn S; Hoch, Jeffrey S; Goering, Paula.
In: Canadian Journal of Psychiatry, Vol. 46, No. 6, 2001, p. 488-495.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Using financial incentives to promote shared mental health care
AU - Dewa, Carolyn S
AU - Hoch, Jeffrey S
AU - Goering, Paula
PY - 2001
Y1 - 2001
N2 - Objectives: To consider the most common primary care reimbursement structures, to identify incentives inherent in each, and to discuss how each could be used to encourage a shared-care approach to treating mental disorders at the primary care level. Method: Three major financial reimbursement models - fee-for-service, capitation, and blended payment mechanisms - are examined. Each is considered in terms of its risk-sharing elements and the consequent incentives. We offer several scenarios to illustrate how the shared-care practice model might be encouraged under each financing mechanism. Results: The current fee-for-service system does not encourage shared care. For wide adoption of the shared-care practice model, there must be a change in the reimbursement system's incentives. While none of the financing mechanisms offers a perfect solution, each has potential. Each, however, must be carefully tailored to its environment. Conclusions: Financial considerations are just one aspect to achieving shared care. Nevertheless, in designing a system to encourage collaborative, coordinated care for those suffering from mental illness, decision makers should be wary of creating or maintaining obstacles (financial or otherwise) to provision of accessible, high-quality care.
AB - Objectives: To consider the most common primary care reimbursement structures, to identify incentives inherent in each, and to discuss how each could be used to encourage a shared-care approach to treating mental disorders at the primary care level. Method: Three major financial reimbursement models - fee-for-service, capitation, and blended payment mechanisms - are examined. Each is considered in terms of its risk-sharing elements and the consequent incentives. We offer several scenarios to illustrate how the shared-care practice model might be encouraged under each financing mechanism. Results: The current fee-for-service system does not encourage shared care. For wide adoption of the shared-care practice model, there must be a change in the reimbursement system's incentives. While none of the financing mechanisms offers a perfect solution, each has potential. Each, however, must be carefully tailored to its environment. Conclusions: Financial considerations are just one aspect to achieving shared care. Nevertheless, in designing a system to encourage collaborative, coordinated care for those suffering from mental illness, decision makers should be wary of creating or maintaining obstacles (financial or otherwise) to provision of accessible, high-quality care.
KW - Blended payments
KW - Capitation
KW - Fee-for-service
KW - Financial incentives
KW - Shared mental health care
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UR - http://www.scopus.com/inward/citedby.url?scp=0034818581&partnerID=8YFLogxK
M3 - Review article
VL - 46
SP - 488
EP - 495
JO - Canadian Journal of Psychiatry
JF - Canadian Journal of Psychiatry
SN - 0706-7437
IS - 6
ER -