Day 1: February 28, 2012

Session Chair: Stephen Samis, Canadian Health Services Research Foundation

Activity-based funding:
There is a general recognition of the disincentives associated with fee-for-service payments for physicians and global budgets for hospitals. Activity-based funding is viewed by many as a sort of middle way between the two. “Activities” can be more broadly defined than a single service, and the payments for those activities can be adjusted based on patient case mix and/or the incentive the funder wishes to put on the service. This session will cover experimentation with activity-based funding.

Pay-for-Performance:
Some funding systems and innovations are aimed specifically at paying based for outcomes rather than simply output. These are often formulated as incentive payments for providers. The potential impact of these incentives is quite different for different providers. Speakers in this session will provide information on the promise and pitfalls of “P4P” in its various forms.

Anne‐Marie Broemeling (Alberta Health Services)
Les Vertesi (BC Health Services Purchasing Organization and Simon Fraser University)
Stephen Peckham (London School of Hygiene and Tropical Medicine)

Session Chair: Robyn Tamblyn, CIHR Institute of Health Services and Policy Research

One question people may ask is whether different funding arrangements that still fundamentally stay within health care sectors really have any hope of fundamentally altering the quantity and quality of health care services provided. Another set of funding models try to work across sectors, promoting integration either in a couple of sectors(e.g. acute and community) or across the whole health care system. Yet another set of funding models try to use financial incentives to motivate improvements in health outcomes. This session willdescribe some of these broader funding efforts, drawing on innovations from both within and outside of Canada.

Matt Sutton (University of Manchester)
Susan Fitzpatrick (Ontario Ministry of Health and Long-Term Care)
Brian Golden (The University of Toronto & The University Health Network)

Session Chair: Anne McFarlane, Vice President, Western Canada and Developmental Initiatives, Canadian Institute for Health Information

The Institute for Healthcare Improvement is interested in “…motivating and building the will for change.” The change envisioned is that which will ensure safe and effective health care to improve population health while controlling growth in cost – the Triple Aim. This session will explore the relationship of funding arrangements – how systems and providers are paid – and the relationship both to the desire for and the capacity to change and improve.

Maureen Bisognano, Institute for Healthcare Improvement, U.S.

Day 2: February 29, 2012

Session Chair: Margaret McGregor, University of British Columbia

How should we measure high quality health care? What quality/outcome measures and data systems need to be in place to ensure that systems are, in fact, paying for what they wish to be purchasing? How essential are payment levers anyway? What are the advantages of "top-down" vs. "bottom-up" quality improvement? This session will feature speakers on measuring and monitoring quality, and the benefits and limitations of tying accountability for quality or outcomes to funding. Speakers from Canada, England and the US will describe their experience and debate the merits of various approaches to this question.

John Wasson (Dartmouth Medical School)
Terry Sullivan (Canadian Partnership Against Cancer)
John Appleby (King’s Fund, UK)

Session Chair: Charlyn Black, Centre for Health Services and Policy Research

There are both fundamental similarities and striking differences in the funding structures in heath care systems across the globe. What may work quite well elsewhere may or may not be a good fit for Canada. What can we learn from others, and where do we have to go it alone? How can we capitalize on different innovations occurring in different parts of the country? This final session will build on the lessons of the conference to speak to Canada’s potential futures and will include: inter-provincial similarities and differences and what else needs to change (beyond funding)?

Dan Florizone (Deputy Minister of Health, Saskatchewan)
Duncan Campbell (Vancouver Coastal Health Authority)
Adalsteinn Brown (University of Toronto)

• Steven Lewis - Health Care Consultant, Saskatoon