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Alternative Payments (AP) represent the remuneration provided to physicians who deliver services through methods other than fee-for-service. The AP models included within the scope of the Physician Master Agreement include Service Contracts, Sessional Contracts and Salary Agreements. Approximately 30% of physicians in British Columbia receive remuneration through AP models.
Alternative Payment Update – September 2024
In August, the Government announced its Workload Funding Process decisions for 2024/25 for Service Contracted and Salaried Physicians experiencing significant and sustained increases in workload.
In total, 96 applications requesting funding for 269.6 FTEs were submitted by Physicians.
Pursuant to the processes outlined in the 2022 Alternative Payments Subsidiary Agreement, the Government has allocated $42.4 million dollars to support 103.2 new FTEs. 80 of the 96 applicants received additional funding through the Workload Funding process this year.
Future Workload Funding processes will be determined as part of the 2025 PMA Negotiations.
2024/25 Workload Funding Process Decision Summary
The 2024/25 Workload funding summary can be found here.
Alternative Payments Update – April, 2024
The 2022 PMA provided Service Contracted and Salaried Physicians with General Increases, Cost of Living Increases and, if applicable, Allocation Committee Increases.
The 2022 PMA General Increases were applied to the Payment Ranges on an equal dollar per FTE basis, based on 3.0% for 2022/23, 2.0% for 2023/24, and 1.0% for 2024/25. The equal dollar increases for the Service Contract Payment Ranges and Salary Agreement Payment Ranges are as follows:
Year
Service Contract Payment Ranges
Salary Agreement Payment Ranges
2022/23
$11,022
$9,841
2023/24
$7,348
$6,561
2024/25
$3,568
$3,186
The Cost of Living Increases are applied on an across the board basis to all of the Payment Ranges. The Cost of Living Increases are 1.25% and 1.0% in 2023/24 2024/25, respectively.
The General Increases for 2022/23 and 2023/24 as well as the Cost of Living increase for 2023/24 were applied on an interim basis pending the conclusion of the Allocation Committee on further targeted increases.
The Allocation Committee, a joint committee of Doctors of BC and Government representatives, reached an agreement on the allocation of $31.2 million over the three years of the PMA to address issues of disparity between the different practice categories and increased cost of business. The consensus decision of the Allocation Committee describing agreement and increases can be found here.
The adjusted Service Contract and Salary Agreement Payment Ranges, inclusive of General Increases, Cost of Living Increases and Allocation Committee increases, are found below:
2023/24 and 2024/25 Workload Funding Process Decisions
The 2022 PMA provided for a total of $128.75 Million to fund additional full-time equivalents of Physician Services (the FTEs) to address workload pressures of Physicians on Service Contracts or Salary Agreements. This funding was released over two years. The outcome of the funding process resulted in a decision in November 2023 to allocate the first $86.35 Million for the 2023/24 fiscal year, and in August 2024 [DE1] the remaining $42.4 Million was allocated for 2024/25 fiscal year, thereby fully allocating the $128.75 Million provided for in the 2022 PMA.
Future Workload Funding Processes will be determined under the 2025 PMA.
The2022 Alternative Payments Subsidiary Agreement (APSA) is negotiated between Doctors of BC and Government. Part of the Physician Master Agreement (PMA), APSA details the employment conditions, contract standards and remuneration rates for all non-fee-for-service physician compensation.
Service Contract
A service contract is between a physician as independent contractor and an Agency or the Government. A service contract will detail specific deliverables and working conditions, a level of service (usually expressed in hours per year) and a rate of remuneration based on FTE designation and range placement.
A session is defined as 3.5 hours of service. Sessions can consist of clinical or administrative work, or a combination of both. Rates of remuneration for sessions are negotiated between Doctors of BC and the Government and are listed in APSA.
Salaried physicians are considered employees of the organization with which they enter into a Salary agreement. As such, these physicians receive regular scheduled remuneration along with any benefits or special employment arrangements provided by the employer.