In the late 1990s, Ontario inaugurated “Primary Care Reform” characterised by the sequential introduction of a “menu” of payment models replacing traditional FFS payment for family physicians. This reform was brought about by, in part, concerns regarding a shortage of family physicians and about access to physicians during evenings and weekends. Improving health care quality, for example increasing the payment system’s support for preventative health care and chronic disease management, was also an important goal. The FFS payment system was seen as contributing towards an excessive focus on volume-based acute care, and to lack incentives encouraging both physician and inter-professional teams (Kantarevic and Kralj, 2015). Physicians were given a choice of payment model. These newly introduced models required or encouraged patient enrollment (sometimes called rostering) with GPs.