Effective February 1, 2023, the Ministry has introduced a new payment model for family physicians with the goal to help stabilize longitudinal family practice and make it sustainable for physicians.
In this blog, we share the most recent updates to the new payment model and how we can help physicians understand the potential impact the changes can have on their practice.
Overview of the New Payment Model
The Longitudinal Family Physician Payment Model is designed to enhance the existing fee-for-service model by combining fee codes with elements from other payment models.
The main highlights of this new payment model include:
- Compensation to address rising business costs, equitable funding that encompasses all your work, and recognition of the value of physicians who provide longitudinal care.
- Compensation for the time you spend on clinical administrative tasks and indirect patient care, including clinical teaching.
- Compensation for time spent with patients, number of patient encounters, panel size, and complexity of attached patients.
- Continued business autonomy, giving you the flexibility to create the kind of practice that works best for you and your patients.
For a physician to be eligible for compensation through the new model, the physician must satisfy the following six requirements:
- Provide longitudinal family physician services to a known panel of patients for a minimum of one day per week.
- Provide both in-person and virtual care, consistent with guidance from the College of Physicians and Surgeons of BC.
- Work with other physicians and healthcare providers in your community to provide care.
- Encourage patients to participate in a provincially administered primary care survey.
- Bill using simplified time and encounter billing codes.
- Provide a list of your active patients to a provincial system on an annual basis.
Compensation Under the New Payment Model
Physicians will be compensated through the following three categories: payment for time, payment for patient encounters, and panel payment.
Payment for Time
As part of the new payment model, physicians will be paid $130/hour for their time spent doing clinic-based work including reviewing test results and writing referrals.
Payment for Patient Encounters
A physician will be paid on average $25 for every standard encounter with a patient. The patient encounters can be in-person or by phone/video using the respective encounter codes. Current fee codes from the MSC Payment Schedule will not be billable for most in-office care and home visits if you choose to move to this payment model.
Here’s an example:
If you have seen three patients in one hour, your hourly rate would be
$130 + ($25 x 3) = $205.
In addition to payment for time and encounters, physicians will also be paid a panel payment. A panel payment is a payment based on the number of attached patients a physician has and the complexity of those patients. They will be paid on average $34 per attached patient per year (higher or lower based on patient complexity).
There will be more information to follow in the next year on how the panel payment will be calculated.
Since the new payment model does not require a contract, physicians will need to bill a portal code (similar in concept to 14070) to switch to this new model. The code has yet to be announced. Billings and payments will continue to be administered through MSP or Teleplan.
We have created a quick reference guide to summarize these details. You can download the guide here.
We Can Help You Get Started
Is switching to the new model right for you? We can help you figure it out with a complimentary practice billing assessment. We will do an income analysis to show you how switching can impact your practice.
Our offering will follow these three phases:
- Phase 1 – Evaluate the payment model
- Phase 2 – Help complete paperwork to shift the appropriate model for you
- Phase 3 – Ongoing maintenance and optimization of the practice
If you have any questions, please don’t hesitate to contact us!
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We will continue to monitor changes and guidance from the Ministry around the new payment model and will be providing regular updates, resources, and support as we receive more information.
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