Paying Up for Paying Out: Tracking Trends in Patient Satisfaction at Mid-Main Community Health Centre

The purpose of this report is twofold. The first purpose is to assess whether there has been an appreciable change in patient satisfaction at Vancouver’s Mid-Main Community Health Centre in response to a transition in remuneration methods from salary to fee-for-service. This was accomplished through the administration of a patient satisfaction survey capturing both quantitative and qualitative data. Based on the 179 received responses it was determined that patient satisfaction did not differ significantly after the transition. However, the survey results, combined with expert interviews with individuals involved in primary care, and an examination of the literature on the topic, suggests that fee-for-service is not the optimal primary healthcare remuneration method. The second purpose of this report is to assess the trade-offs between four remuneration methods: enhanced fee-for-service, capitation, salary, and a blended model of capitation and enhanced fee-for-service. Ultimately, this report finds that the medium-term policy goal for Mid-Main, and clinics like it that want to engage in interdisciplinary models of care, is to attempt to transition to the blended model of capitation and enhanced fee-for-service.