OMA urges doctors to vote for proposed fee agreement

The Ontario Medical Association and the province’s Ministry of Health have hammered out the details of a new physician services agreement covering the period from April 1, 2021 to March 31, 2024–a departure from previous agreements, which have generally covered four years. The OMA announced yesterday that its board has voted to recommend membership ratification of the proposed agreement, which was signed by association and health ministry representatives on Feb. 10. “We believe that it is a better alternative to arbitration and yields more benefits, and in more areas, than would likely be awarded by the Kaplan Board of Arbitration,” Dr. Paul Conte, the OMA’s board chair, said in the announcement, which described the proposed agreement as the “culmination of more than two years of consultation, negotiation, and intense mediation.” A summary drafted by the OMA's counsel underlined the government's voluntary agreement that, under the proposed deal, there will be no cap or clawback on any payments to physicians. Read: Health Canada considering Evusheld for COVID-19 pre-exposure prophylaxis The proposed agreement sets out fee increases for each of the three contract years. According to a copy of the deal obtained by The Medical Post, for the 2021-22 contract year, doctors can expect a lump sum equivalent to a 1% increase to all physician payments, except hospital technical fees and OMA Priority Insurance Program (OPIP) benefits. This lump sum will be paid in February 2023, it states. A further increase of 1% can be expected for the second contract year. For this year, doctors can expect a lump-sum payment equivalent to a 2.01% increase, reflecting the 1% increase for each of the first two contract years. According to the proposed agreement, this will be paid "prospectively" on a monthly basis and flowed through to non-fee-for-services payments "as soon as is practicable." The proposal calls for one-quarter of the global increase to be allocated on an equal percentage amount to each physician grouping with the rest to be allocated to each grouping based on a score derived from a combination of the OMA'S Comparison of Average Net Daily Income relativity tool with the health ministry's Relativity Adjusted Annual Net Income tool. Read: A deep dive into the OMA's proposed plan to embrace ambulatory surgery centres in Ontario In the third contract year the increase to physicians will be determined by establishing a base consisting of pre-COVID 2019-20 expenditures plus the compensation increases awarded for the 2017-21 fee agreement. This adds up to a base of $14.042 billion, with proposed increases of 3.6% a year for four years–to factor in presumed utilization–for a total of $16.1759 billion. "This 3.6% utilization assumption is higher than the historical average growth in the physician services budget, and therefore can reasonably be seen to favour physicians," the summary from OMA's legal counsel states. Based on this equation, if actual physician service budget expenditures in the third contract year is between $16.1759 billion and $15.8587 billion, the difference will be allocated entirely to physicians. In addition, if actual physician service expenditures in the third year is less than $15.8587 billion, the difference between this total and actual expenditure total will be allocated 75% to physician payments and 25% to government. There will be no financial liability for physicians if expenditures under the province's physician services budget exceed $16.1759 billion. Read: Negation driving many Ontario family doctors to distraction In addition to the compensation increases in the first and second contract years, the proposed agreement includes increased funding for pregnancy and parental leave, and for OPIP payments. For any pregnancy and parental leave starting April 1, 2022, the deal calls for increasing the weekly maximum to $1,300 from the current weekly maximum of $1,035. The proposed agreement also includes $12.5 million in new funding to lift the existing moratorium on new hospital on-call groups. At the same time, groups of less than five providing on-call coverage can apply for the same level of payment as groups of five or more, provided they deliver the same level of interrupted call. A new, "burden-based" hospital on-call coverage program is also part of the proposed agreement, to be funded by up to one-fifth of the third-year increase, to a maximum of $75 million. The proposed agreement also addresses alternate payment plans, with provisions for funding towards new plans or expansion of existing plans. Up to one-tenth of the third-year increase, to a maximum of $$50 million, will be used to provide this alternate payment plan funding. Member voting on the proposed agreement opens on March 22 at 10am eastern standard time and closes on March 27. Results will be validated and communicated to members on March 28, according to an OMA announcement. “During the next three weeks, the OMA will undertake a comprehensive and multifaceted effort to explain the full details of the (proposed agreement) with all members, including providing extensive online resources, multiple virtual education sessions, regular email updates, and prompt response to member questions,” Dr. Conte said in the announcement. “A cross functional team of senior staff and OMA leadership is meeting daily to support the member education and ratification process. I will be providing regular updates via email.” Read: QUIZ: Test your knowledge of chemotherapy treatments and side effects

OMA urges doctors to vote for proposed fee agreement

Register for free access or login.

Related Topics