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Colleagues,
Recently, you will have received one of 33,000 tailored emails to practicing physicians across the province to highlight the recommended changes to the Schedule of Benefits (SOB), effective April 1, 2020. These recommendations were made by the Medical Services Payment Committee (MSPC), a bilateral committee of the Ministry of Health and the OMA.
I made a commitment early on in my Presidency (and in my election platform) to bring as much transparency and understanding to how the OMA functions on issues like this. This follow up email is meant to continue to provide more information.
The good news, of course is that effective April 1, 2020, more than 28,000 OMA members — 94% of the profession — will receive their first fee increase since September 2011. Additionally, there will be a 3.54% increase to all IHF and office-based technical fees, as well as increases to APPs and programs outside of the Schedule of Benefits.
The Kaplan Arbitration Award, and the direction of Council and the Board, mandated that the fee allocation process address both intersectional and intrasectional relativity. As a result, five Sections received zero allocation – i.e. no overall increase to their budgets (cardiology, diagnostic radiology, gastroenterology, ophthalmology, and radiation oncology).
This means the not so good news is that on April 1, about 1,900 members will get little or no increase – with an average potential negative impact of about $400 per physician.
Everything you need to know about the Year 4 Fee Changes is available on the OMA website here. There are charts and interactive tables that will allow you to apply recommendations to your own practice. You can also see how fees are allocated across every Section and Medical Interest Group.
I want to acknowledge that the MSPC process has not been without its challenges. But we (myself, the Board and the OMA) are committed to dealing with these challenges in a fair manner.
The MSPC applied a mathematical formula to balance the requests of various Sections and MIGs, in some cases resulting in unintended impacts on fee codes shared by various groups. This has raised concerns among some groups, and we are working with the Chairs of these groups to answer questions and provide follow up.
Other groups have expressed concerns around the rationale and decision-making underlying specific recommendations. We also take these concerns seriously. As a first step, we were able to get the MSPC co-chairs to have face to face meetings with Section and MIG executive members to get answers to outstanding questions. These meetings will begin tomorrow,
Concern has also been expressed that the timeline for the Year 4 fee allocation process was far too short (three months). However, I would respectfully point out that this was necessary IF we wanted to ensure that members got a fee increase on April 1st. Otherwise, we would be dealing with the retroactive pay issues from the Ministry, and we all know how long that takes (The Year 3 retroactive payments are not coming until February of 2021!).
It is true that the majority of Section and MIG chairs I have spoken to so far are supportive of the decisions and methodology carried out by the MSPC. However, we must as a profession and as an organization recognize and acknowledge that some are not, and they do have legitimate questions about the process. I commit to you that we will be undertaking a thorough postmortem of all aspects of the MSPC work and the results will be shared with members.
At the same time, the Board will be considering alternative fee allocation methods going forward so that no member experiences a decrease.
If you have any questions about the process or require any assistance in interpreting how you will be affected by the April 1, 2020, fee changes, our staff are ready and able to walk you through it. Email mspc@oma.org and we’ll get on it.
Enjoy the Family Day Weekend! And remember,
Ontario Doctor’s Rock!
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