Coming Soon: Patient-Centred Care and Self-Directed Funding
Ontario’s Minister of Health and Long-Term Care recently made an interesting announcement that could have a far-reaching impact on the way in which community and home supports are provided in the province. The Minister announced the imminent launch of a number of pilot projects that will offer clients/patients and their families control over funding for community and home care.
This is not an entirely new idea; it has been tested in other sectors (developmental services; services for people with physical disabilities), with some success. In the health sector, however (to which community and home supports are closely related), this will be an experiment of some significance.
What should we be watching and preparing for?
1. The need for home and community care organizations to up their marketing game. If we are putting dollars in the hands of consumers, agencies will need to compete for their business. Marketing will become a more important component of an organization’s annual plan than it has had to be in the past.
2. The shift in “power” is a huge culture shift that agencies will need to acknowledge and to which they will need to adapt. Consumers with dollars to spend can “vote with their feet”. The role of Client Services managers will increase in importance. The relationship between agencies and clients will take on a different tone.
3. The possibility that more private sector providers will emerge, increasing competition and pushing the not-for-profit sector to increase value for money.
4. The importance of an educated consumer. Let’s face it, patients and clients, while they may be at the centre of their care, are by definition more vulnerable, sick, and in a weakened position. Without strong advocates at their side, patient-centred care, and self-directed funding, are notions that are largely meaningless. So do we run the risk of self-directed funding going only to a less marginalized consumer, or one who is more health literate?
5. What role will the LHINs play in this initiative? Undoubtedly they will be involved; the question is whether they will facilitate or hinder the innovation process.
6. The same old bottlenecks. It will be nice to have dollars to use to select your provider of choice. But if your choice is PSW care, for example, good luck to you. Existing systemic issues will pose the same challenges for a self-funded client as they currently do for existing agencies.
The current state of health care is fostering all kinds of interesting discussions about new and innovative ways of delivering service. Dr. Jeffery Turnbull at The Ottawa Hospital (and former Chair of the Canadian Medical Association) is talking about taking health care to the patient (and the demise of the hospital). The province’s HealthLinks projects are intended to break down artificial barriers to bring coordinated care to individuals who use the health care system the most. Some of these ideas will flourish; others will perish. But it’s important to have room in the sector for pilot projects and trials that just might pave the way to improvement. The self-directed funding project will be one such project to watch.
