Can a Fee-for-Service Model Reduce ED Wait Times?

Fee-for-service (FFS) payment models have the potential to motivate physicians to see more patients, but they could also promote overtesting and “cherry picking.”

To determine how an FFS model would affect emergency department (ED) physicians, investigators analyzed ED visits at two large Vancouver hospitals, one of which changed from a contract model (hourly pay regardless of productivity) to an FFS model, while its sister hospital continued using a contract model, creating an elegant opportunity for a natural experiment. Investigators used an interrupted time-series approach to analyze more than 142,000 ED visits during a 42-week period in 2015.

Immediately after the intervention, the median wait time to be seen by a physician (the primary …