Ontario is embroiled in a stormy wage negotiation with its 25,000-plus doctors as the government tries to freeze the $11 billion a year it spends on physicians.
But lost in the back and forth is the complexity of the ways that doctors actually get paid, which explains why the province’s attempt to curb their incomes is not so simple. (And the raw arithmetic ignores the fact that roughly 30 per cent of the payments cover office expenses including salaries for office staff.)
There are three broad categories of compensation:
Fee for service, $8 billion: About 95 per cent of Ontario doctors are paid, at least in part, on a fee-for-service basis. They bill the Ontario Health Insurance Plan a standard amount for each service performed. There are more than 8,000 different fee codes contained in the 800-plus page “schedule of benefits.” Fee codes exist for everything from regular office visits to trauma care, and from chronic disease management to after-hours work.
This schedule is updated at least every four years in negotiations between the OMA and province in an attempt to reflect the time and complexity associated with specific procedures. Both factors can change because of advances in technology and practice methods. It’s for this reason that Health Minister Deb Matthews earlier this week announced reductions for 37 procedures and services, a move that angered doctors because it was done unilaterally.
The province is trying to move away from fee-for-service, a payment method criticized for emphasizing volume over quality. Many doctors, particularly solo practice family physicians, allot only 15 minutes for a patient visit, during which only one problem can be addressed. The arrangement doesn’t work well for patients with multiple health problems.
more/related:
Canada News: How Ontario
Canada News: Ontario doctors appeal to public in contract dispute with province - thestar.com
But lost in the back and forth is the complexity of the ways that doctors actually get paid, which explains why the province’s attempt to curb their incomes is not so simple. (And the raw arithmetic ignores the fact that roughly 30 per cent of the payments cover office expenses including salaries for office staff.)
There are three broad categories of compensation:
Fee for service, $8 billion: About 95 per cent of Ontario doctors are paid, at least in part, on a fee-for-service basis. They bill the Ontario Health Insurance Plan a standard amount for each service performed. There are more than 8,000 different fee codes contained in the 800-plus page “schedule of benefits.” Fee codes exist for everything from regular office visits to trauma care, and from chronic disease management to after-hours work.
This schedule is updated at least every four years in negotiations between the OMA and province in an attempt to reflect the time and complexity associated with specific procedures. Both factors can change because of advances in technology and practice methods. It’s for this reason that Health Minister Deb Matthews earlier this week announced reductions for 37 procedures and services, a move that angered doctors because it was done unilaterally.
The province is trying to move away from fee-for-service, a payment method criticized for emphasizing volume over quality. Many doctors, particularly solo practice family physicians, allot only 15 minutes for a patient visit, during which only one problem can be addressed. The arrangement doesn’t work well for patients with multiple health problems.
more/related:
Canada News: How Ontario
Canada News: Ontario doctors appeal to public in contract dispute with province - thestar.com
