HealthcarePapers 18(3) October 2019 : 29-40.doi:10.12927/hcpap.2019.25928

What “Value” Should We Pay for? A Path Towards Value-Based Payment in Canadian Healthcare Systems

Erik Hellsten and Irfan Dhalla


There is broad consensus that achieving a "value-based" healthcare system requires a shift toward "value-based payment," but less agreement on what this entails beyond moving away from fee-for-service reimbursement. Opinions diverge on the ideal end-state payment model, and the evidence base remains equivocal. We propose a framework for Canadian payers interested in pursuing value-based payment reforms that draws lessons from two widely recognized examples of paying for value in healthcare: the US Center for Medicare & Medicaid Innovation and Canada's own experience using health technology assessment to inform payment policy.



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