With new graduates beginning their careers in family medicine and more physicians relocating to Ontario, many are exploring the Family Health Organization (FHO) model as a starting point. One of the biggest questions early on is: How do I secure a steady income while setting up my practice?
Whether you’re just getting started, planning a move to Ontario, or considering transitioning to a FHO, the Income Stabilization program was designed to help with exactly that. It provides consistent monthly payments during your first year, offering financial stability while you build your patient roster and establish your practice.
In this blog, we walk you through everything you need to know about the Income Stabilization program – from eligibility criteria and payment structure to patient enrollment requirements and timelines.
What is the Income Stabilization program for Ontario physicians?
The Income Stabilization program, developed by the Ministry of Health, provides financial support for physicians who have joined a FHO while they develop patient rosters prior to converting to the group-based blended capitation model. This means you’ll receive a guaranteed payment for up to 12 consecutive months when you join a FHO or FHN, as long as you meet your monthly enrolment targets.
Who is eligible for the Income Stabilization program?
There are three primary criteria to consider for eligibility for Income Stabilization:
- First and foremost, physicians must be starting a new practice, not transferring a roster from an existing physician. They also need to be actively enrolling patients in the FHO model.
- Additionally, if you are currently participating in any patient enrollment models, including FHO, FHN, FHG, or CCM, or if you maintain a patient roster, you will not qualify to apply.
- Please note that participation in the Income Stabilization Program is limited to one instance only. If you have previously taken advantage of this opportunity, you will not be able to participate again.
Also, keep in mind that exceptions may apply, so do not hesitate to reach out to the DoctorCare team with any questions. We are here to assist you in navigating your options.
How much support can you expect? Income stabilization payments explained.
With the IS program, you must meet requirements for patient enrolment, patient treatment, and after-hours services in order to start receiving your stable, guaranteed monthly income.
This chart illustrates how much you will be compensated annually depending on your Full Time Equivalent (FTE) ratio. This rate increases each year based on the awarded compensation through the PSA:
FTE Ratio | Weekly Service Commitment | Annual IS Compensation as of April 1, 2020 | ||
Hours per week | Days per week | Urban | Rural | |
1 | 40 | 5 | $204,773.23 | $224.590.00 |
0.9 | 36 | 4.5 | $184,295.91 | $202,131.00 |
0.8 | 32 | 4 | $163,818.58 | $179,672.00 |
0.7 | 28 | 3.5 | $143,341.26 | $157,213.00 |
0.6 | 24 | 3 | $122,863.94 | $134,754.00 |
0.5 | 20 | 2.5 | $102,386.62 | $112,295.00 |
For example, you will be compensated approximately $200,000 in an urban area if your FTE is 1, which corresponds to a weekly service commitment of 40 hours, 5 days a week.
What patient and enrollment requirements do you need to meet?
By enrolling in the Income Stabilization program, you are also committing to meet specific targets and requirements set by the Ministry in order to remain eligible over the course of 12 months.
1. Patient Enrollment Targets
This chart illustrates the monthly targets a physician must achieve over the course of 12 months, depending on their full-time equivalent (FTE) ratio:
FTE Ratio | Annual Enrolment Target (Cumulative) | Months 1, 2 & 3 Minimum Monthly Enrolment Target | Month 4 through Minimum Monthly Enrolment Target |
1 | 825 | 50 | 75 |
0.9 | 743 | 45 | 68 |
0.8 | 660 | 40 | 60 |
0.7 | 578 | 35 | 53 |
0.6 | 495 | 30 | 45 |
0.5 | 413 | 25 | 38 |
If you do not meet the enrolment target requirements, the Ministry will send you a notification within your first month. By the second month, if you have not achieved your monthly targets, you will be removed from the IS program, and you will transition into a signatory member of the FHO.
Monthly enrolment targets are cumulative, so the Ministry recommends that you proactively enroll more than the target amount to account for vacation, illness, or patients who are de-rostering.
2. Patient Requirements
The patients that you enroll must be either new patients or unattached patients, but how are new patients defined? A new patient must meet one of the following requirements:
- The patient has not previously been enrolled in the group or by a physician in the group.
- The patient’s family physician has moved to another community.
- The patient has moved to another community.
- The patient’s physician is no longer available due to illness/death/retirement.
- The patient’s physician is no longer available due to a change in practice type.
- Or, the patient has not had, or felt the need for, a family physician.
For unattached patients, the criteria remains the same as new patients in addition to one of the following: The patient is a newborn admitted to a Neonatal Intensive Care Unit within the last three months and is not already enrolled with a physician, OR the patient was an acute care patient in a hospital within the last three months, previously without a family physician.
3. Enrolling Patients
Having grasped the type of patients you want to welcome into your care, what steps should you take to bring them onto your roster?
To successfully enroll a patient, it’s essential that they consent to join your practice by signing the Enrolment and Consent (E/C) form. After the form has been signed, you would submit the Q200 code (for non-LTC patients) or the Q202 code (for LTC patients) along with your FHO group identifier number. You should be using the date the patient signs the form as the service date for the claim.
Once the claim is processed, it will automatically connect the patient’s health card number to your billing number in the Ministry’s system and electronically enroll the patient on your roster. Since the Ministry no longer submits the physical E/C form, the final step is to provide the patient with one signed copy and retain one at your office for auditing purposes.
Don’t forget to review the group Error report to make sure your Q200/Q202 claims weren’t rejected due to billing errors.
4. Service Claims Example
After you have successfully registered your patients and begun offering them services, it’s essential to submit a claim for each service rendered. But how exactly do you go about claiming your services?
Physicians in the Income Stabilization program will need to submit FHO claims using the group identifier as a prefix to his/her billing number so that the IS claims will be paid according to the program billing rules. This is important to keep in mind, as payments and claims must be completed through the FHO group account, rather than your solo account, when you are in the IS program.
If the service is provided in a FHO practice office, all services provided by the IS physician to both enrolled and non-enrolled patients will be paid at $0 with an explanatory code I2 – service globally funded.
For services provided outside of a FHO practice office, there are differences for enrolled and non-enrolled patients. For enrolled patients, all services will pay at $0 with an explanatory code of I2 – service globally funded. For non-enrolled patients, you will be paid fee-for-service or based on the contract of the group you are working under.
Common questions about Income Stabilization for new Ontario doctors
We understand that there are numerous components to understanding this program, and it will likely leave you with questions. Here are the most common questions we receive from physicians about the Income Stabilization program:
1. Can I apply for Income Stabilization if I’m an internationally trained physician?
If you are an internationally trained physician, you may apply for the IS program if you meet the eligibility criteria. It is essential for you to ensure that you comply with the requirements, such as not being registered in other payment models. You can apply to be on IS if you are billing fee-for-service.
2. What’s the difference between the Income Stabilization Program and other Ministry incentives like the New Graduate Entry Program (NGEP)?
The Income Stabilization Program (IS) and the New Graduate Entry Program (NGEP) are both initiatives designed to support physicians financially and in other ways, but they do differ slightly.
While both programs aim to assist physicians with guaranteed income, the IS program focuses on:
- supporting those who are new to the province starting out from scratch
- are planning to transition to a FHO
- are not necessarily new graduates developing their practices
- giving a year timeframe to build up their roster
Whereas the NGEP is not tied to a specific enrollment model and is intended for new graduates entering the medical field, with a three-year timeframe to build up their roster.
There is also a guaranteed income difference between how much you can earn when you are in the programs, with NGEP being less than IS and more restrictive on how much you can bill for fee-for-service claims.
With NGEP, you are required to participate in a mentorship program and create a Practice Improvement Plan during the 3 years in NGEP, while being on IS this is not required.
3. Can you still bill FFS alongside the program?
Under the Income Stabilization Program, most service codes aren’t paid out as a monthly payment is already being made. However, there are exceptions for specific service codes that can be billed at the full Fee-for-Service (FFS) value. The relevant service codes that can be billed while on the Income Stabilization Program include:
K990, K991, K992, K993, K994, K995, K996, K997, K998, K999, H055, H065, H101, H102, H103, H104, H105, H112, H113, H121, H122, H123, H124, H131, H132, H133, H134, H151, H152, H153, H154, H400, H401, H402, H403, H404, H405, H406, H407, H408, P006, P020, E502, P018, P041, P042, E500, P038, P009, P010, C989, E411, E414, P045, P046, Z774, P036, P039, P029, P013, P014, P016 and E100
A physician can also be incentivized by having a FFS practice outside of the FHO location. All claims/services provided at the FHO location should be billed through the FHO group number as part of the IS program.
4. What happens if your practice grows faster than expected?
If your practice grows faster than expected while in the Income Stabilization program, you may decide to leave early. A physician can exit the program if they meet their annual enrollment target before the 12-month mark. To do this, they must give the Ministry at least 30 days’ written notice, stating their intention to end their participation in the program.
It’s essential to track your enrollment progress to ensure you meet the program’s requirements.
5. What happens at the end of my 12-month enrollment in the IS program?
The Ministry will regularly assess your actual FHO income against the guaranteed stabilization amount. Once your earnings surpass that threshold, your stabilization payments will gradually reduce or stop. You won’t need to cancel anything manually; this happens automatically based on your billing data.
How can I apply for the Income Stabilization program?
The process is very similar to the process of joining a FHO which we outline in our webinar “Starting your Practice in Ontario: A FHO Primer”, with the additional expression of interest (EOI) document where you would opt in to IS.
If you are looking to join a FHO and are interested in learning more about the Income Stabilization program, we can help!
At DoctorCare, we support approximately 25% of all FHOs in Ontario and have guided many physicians through the Income Stabilization registration process. Once you’re enrolled, our team can assist with patient enrollment, practice setup, and billing, ensuring you’re on track to meet program requirements and build a stable, growing roster.
Beyond the program: Building your FHO practice for long-term success
The end of Income Stabilization support marks the beginning of revenue independence. Maximizing your access bonuses, chronic disease incentives, and after-hours premiums can make a significant difference. This is where support from a billing partner like DoctorCare can ensure you stay optimized beyond the transition period.
Contact Us
Ready to join the Income Stabilization program and begin your path to becoming a FHO doctor? We’d love to connect with you!
