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Fee-for-service payments: down, but far from out

Fee-for-service (FFS) payments, which have anchored physician remuneration in Canada for decades, appear to be beating a slow but steady retreat in the face of growing popularity of other payment methods. Particularly popular are “blended payments” that combine different types of payments, from FFS to service contracts and practice incentives.

According to the CMA's Canadian Collaborative Centre for Physician Resources (C3PR), the proportion of MDs receiving at least 90% of their professional earnings from FFS has dropped from 66% in 1996 to 38% in 2013.

After analyzing data from the 2013 National Physician Survey (NPS), C3PR concluded: "The era of most physicians being paid solely by the fee-for-service method is over."

Its analysis of the NPS results also determined that FFS remains most popular in Alberta, where 47% of doctors reported getting at least 90% of their income via such payments. It is least popular in Prince Edward Island (14%) and the territories (10%).

Meanwhile, blended payments are most popular in PEI (55%) and New Brunswick (49%).

"Fee-for-service is by no means gone," says Lynda Buske, the C3PR manager. She pointed out that even physicians receiving blended payments typically received half of their income from FFS billings.

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