If we're going to limit the discussion to the experience in B.C., there are several different initiatives within their patient-focused funding there. One of them is the activity-based funding. Another of them is called the procedural care program, which does bulk contracting with hospitals for incremental surgical volume.
Activity-based funding is across the board, so it weights all hospital activity equally. However, it's for only a small portion of the health authorities' or hospitals' activity. It's about 17% of the health authorities' or hospitals' funding. It applies to only the largest hospitals since they feel that the hospitals can achieve economies of scale without jeopardizing access in smaller communities. It's not across the board, and it probably should not be applied across the board for everyone. They've sensibly, as have many other countries, restricted it to the largest ones.