Shifting the Public-Private Mix: A Policy Analysis of Physical Therapy Funding in Ontario

Abstract

Purpose: Physical therapy (PT) services across Canada are funded through a mix of public and private sources; this mix varies widely and appears to be shifting over time. The purpose of this research was to develop a conceptual framework for documenting and analyzing the public-private mix of funding in Ontario. Methods: Policy case study methodology was used and included triangulation of primary (key informant interviews) and secondary data sources (review of the literature and available documents). Results: We identified three broad categories or tiers for PT funding in Ontario: (1) public, (2) quasipublic, and (3) private. Within these tiers, there are multiple funding streams ranging from global budgets in hospitals to private out-of-pocket payments. Conclusions: Our findings suggest that multiple funding streams, along with significant variation in how clients access PT services and what services physical therapists can provide within each stream, result in a highly fractured and complex public/private funding system, which may have implications for cost, quality, and access.