Fee Arrangements and Fee Shifting: Lessons from the Experience in Ontario

The lessons of user fee experience in Africa.

This paper reviews the experience of implementing user fees in Africa. It describes the two main approaches to implementing user fees that have been applied in African countries, the standard and the Bamako Initiative models, and their common objectives. It summarizes the evidence concerning the impact of fees on equity, efficiency and system sustainability (as opposed to financial sustainabili...

Ontario physicians get liability fee break.

Leasing imaging facilities to referring physicians: fee shifting or fee splitting?

In the face of increasing costs and decreasing reimbursements, many physicians are working harder and making less money. Not all physicians are content working harder for less income. Physicians have chosen other avenues in order to enhance their income. Various ancillary services such as dexa scans and ultrasound studies are being done in physician offices rather than in hospitals. These metho...

Alternative Fee Arrangements: an Idea Whose Time Has Come?

In this new legal economy, many clients have begun to reexamine the concept of alternative fee arrangements (“AFAs”) as an alternative to the billable hour model of legal services. A survey conducted by the Association of Corporate Counsel in 2008 found that 60% of general counsel and chief legal officers believed that the best way for outside counsel to improve relations would be to offer more...

To fee or not to fee.

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