Parallel payers and preferred access: how Canada's Workers' Compensation Boards expedite care for injured and ill workers

Canada's workers' compensation boards (WCBs) finance healthcare for injured and ill workers in parallel with provincial health insurance plans. Parallel systems of healthcare finance can create preferred access for some. WCBs have in recent years pursued a number of strategies to expedite or improve the quality of care for injured or ill workers, including in-house provision in WCB-owned facilities; contracting with private, for-profit clinics; contracting with publicly funded hospitals and clinics for use of facilities 'off-hours'; and supporting specialized clinics within publicly funded hospitals. Many of these strategies incorporate incentive payments to physicians and facilities for treating WCB cases more quickly than patients covered by provincial plans. In this paper we document the development of these strategies and discuss their implications for physicians, patients, government and the provincial public insurance plans