2007 Agreement Reassessment
In 2007 a reassessment of the 2004 Agreement produced a package of new incentives and fees, the majority of which took effect in 2007/2008.
2007 Agreement Reassessment
In 2007 a reassessment of the 2004 Agreement produced a package of new incentives and fees, the majority of which took effect in 2007/2008.

2007 Reassessment

Agreement delivers additional benefits to members

The four-year Physician Services Framework Agreement provides for a mid-point Reassessment to review the Agreement in the context of investment initiatives and changes within the health-care system – an amount of $15 million was assigned to assist with this process.

The Reassessment has concluded successfully, and the OMA Board has approved a package of new incentives and fees, the majority of which will take effect in the fall of 2007 and early 2008. Key components include:

  • A modest "service recognition payment" to all physicians based on their length of continuous service.
  • A package of selected Central Tariff Committee recommendations.
  • Enhancements to various primary care premiums.
  • Extended funding of the Northern Physician Retention Initiative.
  • A one-time payment for surgical specialists who participated in the start up of the Wait Times Information System.
  • A weekly palliative care case management fee.
  • A new committee has been established that will bring together the CEOs of Local Health Integration Networks, the OMA and Ministry to communicate issues of interest at a province-wide level on a continuing basis.
  • Time-limited working groups have been assigned to develop recommendations to address a number of issues.

The Board believes the OMA Team allocated the available resources effectively, and established some important mechanisms to achieve additional enhancements in the future.

Physician Human Resources

General

The Ministry and OMA identifed health human resources as a priority under the Reassessment.

Consolidation of Locum Programs

The Ministry and OMA have agreed to consolidate the administration of their respective locum programs at HealthForceOntario.

Continuing Medical Education

While the administration of the OMA locum program will be transferred, the Ministry has committed to maintain full funding for the OMA CME / Rural Locum Program. This funding will support an expanded CME initiative.

Northern Physician Retention Initiative (NPRI)

NPRI funding will be extended for 2007-08.

Retention Incentive Committee

The Ministry and OMA identifed health human resources as a priority under the Reassessment.

A bilateral committee has been assigned to explore parameters for a competitive retention incentive program.

Service Recognition Payment

Physicians will receive a modest "service recognition payment" based on their length of continuous service in Ontario. Physicians in continuous practice beyond 30 years will be eligible to receive an additional payment. The payment eligibility criteria are set out in Section 6 of the contract.

Pregnancy and Parental Leave Benefit Program

Effective October 1, 2007, the Pregnancy and Parental Leave Benefit Program will be amended to broaden the eligibility requirements beyond fee-for-service and APP physicians.

Repatriation

A relocation support program will be established through HealthForceOntario to encourage physicians who are not currently living or practising in Ontario, and who have a connection to Ontario or Canada, to practise in this province

Primary Care

Unattached Patients

  • The New Graduate - New Patient Incentive (Q033) threshold will increase from 150 to 300 effective October 1, 2007.
  • Effective October 1, 2007, the New Patient Fee premium (Q013) for patients aged 65 to 74 will increase from $110 to $120; and the New Patient Fee premium (Q013) for patients over the age of 75 will increase from $120 to $180.
  • The New Patient Fee (Q013) threshold of 50 patients will be increased to 55 patients effective October 1, 2007, and 60 patients effective April 1, 2008.

Primary Care Payment for Capitated Models

One-time funding has been set aside in recognition of the negative impact on capitated physicians’ access bonuses by GP Focused Practice services. The criteria for the funding are to be developed by the Physician Services Committee.

Obstetrical Coverage

  • Effective October 1, 2007, the Family Health Group (FHG) letter of agreement will be amended to permit the provision of obstetrical deliveries outside regular office hours to be counted towards the exemption from after hours service requirements for FHGs.
  • Effective October 1, 2007, applicable primary care agreements will increase the obstetrical bonus fee from $3,200 to $5,000 for physicians providing a minimum of 5 deliveries per year.
  • Additional financial incentives will be developed for those primary care physicians providing obstetrical care.

GP Focused Practice Physicians

A subcommittee of the Physician Services Committee will assess the impact of the billings of GP Focused Practice Physicians on the access bonuses of physicians in primary care models. Guidelines will be developed to address exemptions for specific GP Focused Practice groups.

Comprehensive Care Model (CCM)

The Comprehensive Care Agreement After Hours Premium (Q016) will increase from 10% to 20%, effective October 1, 2007.

Hospital Care

Wait Time Reduction Payment

  • The Ministry will transfer $3 million to the OMA on October 1, 2007 to recognize physicians who participated in the start-up of the Wait Time Information System initiative. The distribution of funds is to be determined.
  • A subcommittee of the Physician Hospital Care Committee will bring forward recommendations by February 1, 2008 to support the role of physicians in managing access to Wait Time services.
Most Responsible Physician (Hospitalist) Program

A working group will develop, by December 31, 2007, a program for most responsible physician (MRP) services, which will include recommendations for remuneration of full-time hospitalists and community physicians who provide inpatient care.

Palliative Care

A weekly palliative care case management fee code of $51.70 will be implemented into the OHIP Schedule of Benefits no later than January 1, 2008.

Medical Services Payments

Schedule of Benefits

The Ministry will implement a package of fee changes recommended by the OMA Central Tariff Committee. Please refer to Appendix D in the contract for the full listing of fee codes.

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