Primary Care Team Funding, Compensation and Practice Models Across Canadian Jurisdictions: An Environmental Scan

Area of Science:

• Health Services Research
• Primary Care Policy
• Nursing Practice

Background:

• Canadian primary care reforms increasingly emphasize team-based care, frequently incorporating registered nurses (RNs).
• These reforms have historically varied in their approaches to team funding, compensation structures, and organizational models.
• Understanding these variations is crucial for effective implementation and evaluation of team-based care initiatives.

Purpose of the Study:

• To conduct an environmental scan to identify and describe existing primary care compensation and practice models across Canada.
• To map the landscape of remuneration and operational frameworks within Canadian primary care settings.

Main Methods:

• A comprehensive environmental scan was performed.
• Structured and snowball searching techniques were employed to identify relevant data sources.
• Data extraction focused on compensation and practice models within primary care.

Main Results:

• The scan identified 189 sources, yielding data on 44 distinct compensation models and 55 practice models.
• While specific compensation data for registered nurses (RNs) was limited, physician remuneration and practice models showed significant diversity.
• Existing funding, compensation, and practice models demonstrate substantial heterogeneity, reflecting diverse reform strategies and pre-existing systems.

Conclusions:

• The substantial variation in funding, compensation, and practice models, particularly concerning the integration of RNs, presents challenges.
• The lack of clarity surrounding these models impedes the evaluation of team-based care's functioning and effectiveness.
• Further research is needed to understand how different models impact the success of team-based primary care.