Quebec health reform to standardize medical treatment costs

In the latest of several reforms, Quebec Health Minister Gaétan Barrette is looking to change the way the province's health institutions are funded, by standardizing the cost of medical treatments.

The reform, called activity-based or patient-focused funding, aims to evaluate the costs of each type of care in various institutions, reduce the disparity, and set an average price for each health care service offered in the province.

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Budgets paid to institutions would then be established based on these amounts and volume of activity.

Currently, hospitals' annual budgets are based on past budgets.

In 2014, Minister of Health Gaétan Barrette said activity-based funding was "the way to solve, once and for all, the funding disparities between the regions that they've been complaining about."

As a first step in the reform, the provincial government will announce the name of the company that will study the costs for each medical procedure in institutions across the province.

That evaluation process will cost an estimated $70 million over three years. 

Different bill for same procedure

A study conducted in 2011 and 2012 for the Ministry of Health revealed significant differences in costs for the same health service between 12 institutions.

For a hip replacement, the bill ranged from $10,411 to $14,575 and between $820 and $1,475 for an eye operation. For a caesarean section, costs ranged from $2,356 to $4,714 depending on the institution.

When setting the target price under the new reform, Radio-Canada sources said Barrette will not necessarily opt for the lowest cost.

Pierre Gfeller, CEO of the health agency CIUSSS du Nord-de-l'Île-de-Montréal, says the varying costs may be due to differences in volume and complexity of the medical procedure between the regions.

"In Quebec, because of the historical funding formula, we're not very good at determining our costs," said Pierre Gfeller, CIUSSS CEO of North Island of Montreal.

Gfeller added that the government's activity-based funding model may inspire institutions to follow the lead of the more efficient facilities, lessening their overall costs and making it easier for them to adjust to the government's targeted prices.

"This means that with the same budget, we will be able to perform more surgeries."