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) |
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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 |
Keywords
- Blended payments
- Capitation
- Fee-for-service
- Financial incentives
- Shared mental health care
ASJC Scopus subject areas
- Psychiatry and Mental health