Principle | Consequences for selecting incentives | Recommendation |
---|---|---|
(1) Be fiscally prudent | Incentives should not lead to additional costs for the health care system (no new money). | Exclude funding of bonuses/enhanced payment through new money without added value or without future savings. |
(2) Be simple to administer | Incentive should be easy to implement and ideally be executed within existing policies, regulation and legislation. | Exclude 'Flexible oversight/greater autonomy' as an incentive as its design and implementation are too complex or might conflict with existing legislation or regulations. |
(3) Improve equity in access to quality of health care services across Ontario | Incentives should not lead to differences in access to quality of health care services; instead, if possible, strengthen equity. | Exclude withhold of existing funding based on performance. Exclude bonus/enhanced payment funding via reallocation of funding from low to high performers. |
(4) Support a culture of continues improvement, innovation and mutual learning | Incentives should: - not lead to tensions between ministry – LHIN and LHIN – health service providers. - focus on learning and improving rather than blaming. - encourage the sharing of best practices across LHINS and LHIN providers. | Exclude withholding of existing funding based on performance. Design public reporting in such a way that it prevents a "shame and blame" culture. |