A new paper from the C.D. Howe Institute supports the use of capitation payments versus fee-for-service for primary care physicians. The authors point out that there are lessons to be learned from the use of capitation models, and call for a stricter and more consistent approach.

The paper says capitation makes more sense for modern-day family doctors who act more as patient managers—diagnosing, prescribing, and referring—and delivering less direct services than in the past. One problem presented by capitation is patients seeking care from a provider other than their designated primary care provid­er, which tends to drive up costs.

The paper, entitled “How to pay family doctors: Why ‘pay per patient’ is better than fee for service,” can be viewed at www.cdhowe.org/pdf/Commentary_365.pdf [8].