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Primary care reform is proceeding in a number of jurisdic-tions with little attention to the impact of reimbursement type on quality and accessibility of care (Gosden et al., 2001b), especially for complex patients such as adults with long-term disabilities (Kroll, Beatty, & Bingham, 2003). This study was conducted in Canada, where there are three main models used to reimburse primary care physicians: fee-for-service (FFS), capitation, and salary (Tu, Cauch-Dudek, & Chen, 2009). Economic theory makes it clear that different payment models create financial incentives for physicians to maximize income and reduce effort through manipulation of the supply of services (Gosden et al., 2001a; Simoens & Giuffrida, 2004). In some instances, these incen-tives have been shown to be contrary to the needs of more demanding patients (Chisholm & Stewart, 1998; Kasperski, 2005). This study attempts to show how practice factors, particularly payment type, affect quality and accessibility of primary care for adults with disabilities. Fee-for-service is the traditional model of physician reim-bursement, wherein physicians are compensated according to a prenegotiated schedule of rates for particular services. The literature is fairly consistent in positing that fee-for-service payment tends to result in increasing the quantity of medical services offered, in turn increasing ability of patients to be seen and continuity of service (Gosden et al., 2001b); how-ever, quality may be compromised by shorter appointment times and more unmet health needs (Safran, Tarlov, & Rogers