Community-based family physicians who work under fee-for-service and who care for a panel of patients will soon receive a new annual payment to recognize their important role in providing longitudinal care that evidence shows results in better health outcomes for patients.
In introducing the Community Longitudinal Family Physician (CLFP) Payment, the GPSC is taking an important step that acknowledges the foundational importance of longitudinal care. It also recognizes the additional, non-clinical responsibilities required to provide ongoing, coordinated care for which fee-for-service physicians are not compensated.
The first payment will be made in January 2020. Family physicians who are eligible for the payment, as shown through billing data, will receive a CLFP Payment ranging from $3,000 to $12,000. The majority will receive between $4,000 and $8,000. The GPSC has allocated $19.5 million annually for these payments.
Who is eligible
Fee-for-service, community-based family physicians are eligible for the 2019 CLFP Payment if they:
- Have submitted and met the requirements for GPSC Portal Code (G14070) in 2018 and 2019, prior to June 19, 2019, to signify that the physician was and continued to be providing full-service family practice services to patients and confirming physician-patient relationship with existing patients through a standardized conversation or “family physician-patient compact."
- Have 50 or more Majority Source of Care (MSOC) patients in 2018 based on family physician visits provided under fee-for-service.
The exact payment amount per individual physician is based on the number and complexity of Majority Source of Care (MSOC) patients associated with the physician in the MSP database. Click here for more information on MSOC and eligibility.
How it works
The CLFP Payment will be remitted automatically by MSP Teleplan to eligible physicians. This means they do not have to navigate complicated billing rules or meet additional documentation requirements to receive the payment.
The CLFP Payment may be subject to business arrangements pertaining to how MSP payments paid to particular payee numbers are split between physicians and clinic owners. In these cases, physicians and clinic owners are encouraged to come to a mutual agreement on how existing business arrangements apply to the CLFP Payment.
Comprehensive care outside the community practice office setting
The GPSC acknowledges the importance of the comprehensive primary care provided by family physicians outside the community practice office setting, including maternity, in-hospital, and long-term care.
In the past decade, the GPSC has continued to fund enhanced supports to maternity, in-hospital and long-term care. The GPSC has been providing annual funding of $7 million for maternity care, $12 million for long-term care and $25 million for in-hospital care. This amounts to an additional $6,000 to $11,000 on average per physician per year for physicians practicing in those areas.
To further support in-hospital and maternity care in 2019 and beyond, the GPSC approved an additional 30% lift to select in-hospital and obstetrical fee items this year. Eligible physicians will receive those fee increases along with retroactive payments in early 2020.
Going forward, the GPSC will continue to consider ways to further support physicians working to provide this comprehensive scope of primary care.
For questions or more information, contact firstname.lastname@example.org.
How will my payment amount actually be determined?
Payment amounts for each eligible physician will vary according to the number and the complexity of MSOC patients assigned to them. The MSOC methodology is commonly used by the BC Ministry of Health to measure patient attachment to health care practitioners, including family physicians.
The CLFP Payment uses the Adjusted Clinical Group (ACG) methodology to estimate the complexity of each MSOC patient associated with each eligible physician. The ACG methodology enables payment amounts to reflect a wide range of diagnoses and health conditions that can be expected to influence health care utilization.
See the FAQ document for more information about MSOC and ACG methodology.
Will the amount be increased in the coming years?
Any increase in this funding will need to be balanced with the other support needs of physicians including supporting more comprehensive scope of care, team-based care, networks, etc.
The GPSC continues to develop new incentives to support longitudinal family practice in the context of patient medical home and primary care networks. In particular, the GPSC is now focusing on developing new incentives to support team-based care and comprehensive care in the community.
The new CLFP Payment builds on the range of incentives and payments already in place to support full-service family practice including: Panel Development Incentive, care planning and management fees, chronic disease management fees, Personal Health Risk Assessment fee, and patient telephone management fees.
How should this payment be treated by a physician’s business arrangement with their clinic?
The 2019 CLFP Payment is paid to the payee number where GPSC Portal Code (G14070) was first submitted in 2019.
The payment may be subject to local business arrangements pertaining to how MSP Teleplan payments paid to particular payee numbers are split between physicians and clinic owners. In these cases, physicians and clinic owners are encouraged to come to a mutual agreement on how existing business arrangements apply to the CLFP Payment.
What should I do to prepare for next year’s payment?
The exact eligibility criteria for future CLFP Payments is currently being finalized.
If eligible, physicians should continue to submit GPSC Portal Code (G14070) on an annual basis to signify they are continuing to provide full service family practice services to patients and confirming doctor-patient relationship with existing patients through a standardized conversation. More detailed information can be found in the FAQ document.