title: Impact of oncologist payment method on health care outcomes, costs, quality: a rapid review.
abstract: BACKGROUND
  The incidence of cancer and the cost of its treatment continue to rise. The effect of these dual forces is a major burden on the system of health care financing. One cost containment approach involves changing the way physicians are paid. Payers are testing reimbursement methods such as capitation and prospective payment while also evaluating how the changes impact health outcomes, resource utilization, and quality of care. The purpose of this study is to identify evidence related to physician payment methods' impacts, with a focus on cancer control.
  
  
  METHODS
  We conducted a rapid review. This involved defining eligibility criteria, identifying a search strategy, performing study selection according to the eligibility criteria, and abstracting data from included studies. This process was accompanied by a gray literature search for special topics.
  
  
  RESULTS
  The incentives in fee-for-service payment systems generally lead to health care services being applied inconsistently because providers practice independently with few systems in place for developing treatment protocols and practice reviews. This inconsistency is pronounced in cancer care because much of the total per patient spending occurs in the last month of life. Some insurers are predicting that this variation can be reduced through the use of prospective or bundled payments combined with decision support systems. Workload, recruitment, and retention are all affected by changes to physician payment models; effects seem to be magnified in the specialist context as their several extra years of training lower their overall supply.
  
  
  CONCLUSIONS
  Experimentation with physician payment methods has tended to neglect cancer care providers. Policymakers designing cancer-focused physician reimbursement pilot programs should incorporate quality measurement since very ill patients may receive too little treatment when payment models do not cover oncologists' total costs, e.g., fee-for-service systems whose prices do not account for the possible presence of other diseases.
authors.affiliation: Canadian Centre for Applied Research in Cancer Control (ARCC), School of Population and Public Health, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, V5Z 1G1, Canada. mcpherson.emily@gmail.com.
authors.forename: Emily
authors.initials: E
authors.lastname: McPherson
authors.affiliation: Centre for Clinical Epidemiology and Evaluation, University of British Columbia, 828 West 10th Avenue, Vancouver, British Columbia, V5Z 1M9, Canada.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Hedden
authors.affiliation: Canadian Centre for Applied Research in Cancer Control (ARCC), School of Population and Public Health, University of British Columbia, 675 West 10th Avenue, Vancouver, British Columbia, V5Z 1G1, Canada.
authors.forename: Dean A
authors.initials: DA
authors.lastname: Regier
keywords: Activity-based funding; Capitation; Fee-for-service; Oncology; Pay for performance; Payment by results; Physician payment; Physician reimbursement; Prospective payment; Salary