The B.C. government announced last month it’s working on a new physician compensation model, expected to be unveiled later this year.
For many British Columbians, this is just another piece of the primary-care puzzle.
Will the changes have an impact on how patients receive care? Glacier Media interviewed a number of experts for this story to shed light on the current fee-for service model and what’s being developed.
What can be expected from the new model?
Dr. Ramneek Dosanjh, president of Doctors of BC, says the new model will address the rising business costs of running a family practice.
“We’re hoping that this new payment model would help mitigate [rising costs], to meet operating costs, but also to ensure that [physicians] are recognized for the extra time spent on complex-care patients and for the time they spend on administrative work right now that they’re doing, without pay, often into the evenings,” she said.
The new model is slated to be revealed between October 2022 and January 2023.
In addition to announcing a new compensation model on Aug. 24, the Ministry of Health and Doctors of BC said there will be a $118-million investment to cover the costs of overhead. That adds up to $25,000 per physician.
The new model hopes to compensate physicians better for time spent with patients, Dosanjh says.
According to Dr. Rita McCracken, a family physician and assistant professor at UBC, prioritizing time spent with patients within B.C.’s fee-for-service system has been attempted with “time modifiers” — a term used when a physician is billing for a more complex-care patient that may take up more of the physician’s time.
She tells Glacier Media time modifiers are also used in Alberta’s health-care system; however, McCracken says “we are still seeing more family doctors leaving Alberta and coming to British Columbia.”
“By a significant factor,” she said, referring to data from the College of Family Physicians of Canada.
According to McCracken, in 2000, B.C.’s General Practice Services Committee introduced bonus codes that physicians could bill under for people who have specific chronic diseases. These bonus codes would account for the extra time needed to review and apply care.
“There was no change to the outcomes for patients, so there was no reduction in the number of times those patients went to hospital, there was no change in their mortality. We also saw that physicians got paid more and that physicians saw fewer patients,” she said.
She adds there is a “mountain of evidence” showing that bonus codes in a fee-for-service system does not improve patient access.
A 2016 analysis also shows that when incentive payments were used to compensate doctors for complex patient care, there was no improvement on primary access or continuity.
“Policymakers should consider other strategies to improve care for this patient population,” the study said.
Read more…
