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Ontario Health Minister Deb Matthews announced Monday that most Ontario hospitals will see changes in how the government funds them, starting next month. (Pawel Dwulit/Canadian Press)

Ontario's Liberals are moving ahead with changes that will affect the way most Ontario hospitals are funded.

Starting in April, the province will begin reimbursing 91 hospitals for the care they provide, rather than providing only lump sum payments.

Health Minister Deb Matthews says 55 smaller hospitals won't be part of the new funding model.

Of the 91 hospitals affected by the change, Matthews says 60 per cent will see an increase in funding, while 40 per cent will get slightly less.

The 'patient-based' funding model — first promised in 2010 — will comprise almost half of hospital funding this year, ramping up to 70 per cent in 2014.

That means a portion of hospitals' funding would be based on criteria such as how many patients they have, the services they deliver and the specific needs of the population.

The province will also allocate money for four procedures: hip replacement, knee replacement, cataract surgery and dialysis and other treatments for kidney disease.

"Hospitals will get paid a certain amount of money for every procedure they do," Matthews said. 

"This is not about cuts, this is not about saving money. This is, though, about shifting resources."

The patient-based model will create a more efficient system and encourage hospitals to improve patient care, she said.

The government hopes that the move will get people out of hospital sooner and bring down wait times

The province needs to be smarter with its health-care cash, which accounts for nearly half of every dollar it spends, as its population ages, Matthews said.

Susan Eng of the seniors advocacy group CARP was generally supportive of the funding change.

"Efficiency is important to make sure we save money for the things we need to have them do, but we have to be careful that they're not cutting much needed services," she said. 

The Liberals are also facing a $16-billion deficit this year and have vowed to rein in program spending.

But they should have prepared for those pressures on the system, instead of wasting health-care dollars on eHealth and Ornge, the province's troubled air ambulance service, said NDP Leader Andrea Horwath.

With files from CBC News