Introducing value for money could rein in health care spending, says CGA-Canada report

Focus on outcomes alone inadequate

VANCOUVER, May 11 /CNW/ - Injecting tens of billions of dollars into Canadian hospitals with no value measures in place is an inefficient approach to health care spending, says a report from the Certified General Accountants Association of Canada (CGA-Canada).

"While more money can deliver more health care, it won't necessarily be better health care," says Rock Lefebvre, CGA-Canada's vice-president of research and standards.  "Without value-for-money metrics, hospitals and governments can't know if they could have achieved better health outcomes had the same money been invested elsewhere in the system."

Highlights and the full report: Can We Get Better for Less? Value for Money in Canadian Health Care are available via the CGA-Canada website.

In 2010, hospitals in Canada received an estimated $55.3 billion - or 28.9 percent of all health care spending - making them the single largest component of health care spending by provincial governments.  That spending - on staff, hospital beds, technology and the like - is predicted to soar, along with an aging population, longer life expectancies, and costly new innovations. One way to rein in that spending is to embrace value-for-money measures within the health care system.

Before committing to investment in additional physician capacity, hospital beds or diagnostic technology, policy makers could establish consistent and transparent value-for-money measures that reflect access to and quality of care, patient health outcomes and costs, and are monitored and tracked regularly over time and compared across institutions. Uniformly computed and publicly reported value-for-money metrics for all hospitals could enable comparison and allow sharing of best practices.

"Unfortunately our health care system doesn't yet provide benchmarks for the evaluation of effectiveness and efficiency of care delivered," notes Lefebvre. "Reporting and comparing value-for-money measures would give hospital management, taxpayers and policy makers a much clearer picture of what we are all paying for."

Select outcome measures, such as wait times, may be crowding out other measures of quality, according to the report. As well, pay-for-performance programs, while promising, need further analysis of their implementation and success.

In 2008 and 2009, Canada ranked last out of 30 countries in terms of value for money spent as reflected in the Euro-Canada Health Consumer Index. In 2010, Canada's ranking moved to 25th place out of 34 countries (with the United States excluded from the study). And the scorecard released by the Commonwealth Fund ranked Canada sixth out of six countries on the value-for-money dimension.

About CGA-Canada
Founded in 1908, the Certified General Accountants Association of Canada serves 75,000 Certified General Accountants and students in Canada and more than 90 countries. Respected accounting and financial management professionals, CGAs work in industry, finance, government and public practice. CGA-Canada establishes the designation's certification requirements and professional standards, offers professional development, conducts research and advocacy, and represents CGAs nationally and internationally.

CGA-Canada has been active in developing impartial and objective research on a range of topics related to major accounting, economic and social issues affecting Canadians and businesses. CGA-Canada is recognized for heightening public awareness, contributing to public policy dialogue, and advancing public interest.


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Stephanie Thatcher
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Telephone: 604 694-6700

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