Consistency of home care personnel under managed competition [electronic resource]

Abstract

In Ontario, Community Care Access Centres (CCACs) oversee managed competition by home care agencies for service delivery contracts. Contracts are to be awarded to the agencies that provide the highest quality services at the lowest price. We examined the impact of two rounds of competitive contracting for home care services by one CCAC. Specifically, the impact of changes in market share among agencies on the consistency of personnel caring for longer term home care clients was examined. Clients who transferred to a new agency saw about twice as many service providers during an episode of care as those who did not transfer; the mean monthly number of service providers that they saw before and after transfer was not different. Higher service needs put clients at greater risk for transfer to a new agency. The factors associated with greater consistency in home care personnel for clients are also described.