Module 1, Lecture 3

Physiotherapy Practice in Canada

Funding of the Healthcare System

Canadian Health Care System

Provincial and
Government of
Territorial
Canada
Governments
• Sets guiding principles • Administers health plans
• Provides transfer • Plans + funds health
payments delivery
• Delivers service to special • Funds health providers
groups • Funds public health +
• Regulates food, drugs + prevention
devices
 Sources of Funding for Health Care in Canada

70.4% 29.6%

Public Private
CIHI 2020
https://www.cihi.ca/sites/default/files/document/nhex-trends-2020-narrative-report-en.pdf

The Provinces Fund the Majority of Public Health Care

76.5% 23.5%

Provinces Government of
Canada
https://lop.parl.ca/staticfiles/PublicWebsite/Home/ResearchPublications/BackgroundPapers/PDF/2018-45-e.pdf Source: Federal Funding for Health Care, Background Papers
2021
Percentage of Provincial Budgets Spend on Health Care

68% Assumes a
3.5% increase
33% in yearly
health care
costs

2019 2037 Source: CIHI 2014

Sustaining the current levels of health

spending presents a financial challenge for
provincial governments and any policy,
funding or political decision regarding health
care does eventually trickle down to affect
front line delivery of patient care.
 Where Public Funding is Spent

Hospitals Physicians
34.7% 20.8%
of public health of public health
spending spending
Source: CIHI, 2019

Value Efficiency

Cost-effectiveness Do more with less

 The reality for physiotherapists working within
in hospitals is a continual drive to deliver
better care more efficiently. This means
physiotherapists need to be comfortable with
change, open to new ways of delivering
service and be able to demonstrate the value
of their services.

Sources of Funding for Health Care in Canada

70.4% 29.6%

Public Private
CIHi 2020
2021
https://www.cihi.ca/sites/default/files/document/nhex-trends-2020-narrative-report-en.pdf
 Services Covered Under Private Health Plans

Private Health
Benefits

Breakdown of Private Health Spending

31.9%drugs 9% hospitals 19.3% dental

5.7% vision 6.9% PT, Chiropractic,

Massage, Psychology Source: CIHI 2019
6.9%. The amount spent on
other professionals combined (e.g.
physiotherapists, Chiropractors,
Psychologists Acupuncturists and
Massage Therapists)

Source: CIHI 2019

15% of private health

spending is out-of-
pocket payments by the
patient.

Source: CIHI 2019

 Health Care Costs

To contain costs this many private

health insurers will put in place
policies or administrative processes
to limit their risk to rising costs.
Case Management Used By Private Insurers
Physician Case
Worker

Physiotherapist Employer

Case Management Used By Private Insurers

Physician Case
Worker

Physiotherapist Employer
Case Management Used By Private Insurers
Physician Case
Worker

Physiotherapist Employer

The reality for physiotherapists working within in

private practice an increased demand to
communicate and justify treatment plans to case
workers. This requires the physiotherapist to have
the skill and competencies to work collaboratively
with the patient and the insurance case worker to
achieve the best possible outcome.
 In Review

1 The Canadian Health system is 70% publicly funded and

30% privately funded.
1 The Canadian Health system is 70% publicly funded and
30% privately funded.

2 Governments and private insurers are concerned about

health care costs and getting value from the system

1 The Canadian Health system is 70% publicly funded and

30% privately funded.

2 Governments and private insurers are concerned about

health care costs and getting value from the system

Physiotherapists in the public system need to be

3 comfortable with change and willing to embrace new and
evidence based approaches to service delivery
1 The Canadian Health system is 70% publicly funded and
30% privately funded.

2 Governments and private insurers are concerned about

health care costs and getting value from the system.

Physiotherapists in the public system need to be

3 comfortable with change and willing to embrace new and
evidence based approaches to service delivery.

Physiotherapists in the private system need the skills to

4 work collaboratively with insurance companies and to
demonstrate good outcomes.

Thank you
for listening