‘Game changers’: province offers doctors $268-M funding bump, new billing options

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This article was published 20/07/2023 (821 days ago), so information in it may no longer be current.

Manitoba doctors are being offered a $268-million hike in government funding to increase salaries, spend more time with patients, and attract physicians to rural and northern communities as part of a new four-year service agreement.

On Thursday, Doctors Manitoba announced it is recommending its members ratify the tentative physician services agreement proposed by the provincial government.

Under the tentative agreement, doctors would receive a market adjustment and a special retention payment in the first year, followed by compounding two per cent annual general increases for service fees in the three remaining years.

Doctors Manitoba president Dr. Michael Boroditsky hailed the proposal as “historic,” with game-changing adjustments to the funding model for family physicians.

“We’re hoping that it’s going to recruit and retain more physicians in the province with competitive remuneration and stable funding,” Boroditsky said Thursday.

“We’re hopeful that this will help see stabilization in the ER, surgical wait times will decrease. We’re hoping more Manitobans will be able to find family physician, and we hope that patients and physicians can find they can spend more time on more complex medical concerns.”

The $268-million funding increase is the largest in two decades, according to the province.

Between April 2019 and March 2023, provincial spending on physician services increased by $23 million, as doctors accepted the Tory government’s two-year public-sector pay freeze, followed by general rate increases of 0.75 and one per cent.

In the 2023-24 fiscal year, the province has budgeted $1.48 billion to cover services insured under the Manitoba Health services insurance plan, including fee-for-service claims submitted by doctors and non-fee-for-service payments.

The tentative agreement includes a new longitudinal family medicine funding model, intended to boost the number patients on doctors’ rosters and incentivize physicians to spend more time with patients who have chronic medical concerns.

The proposed funding model builds on frameworks introduced in British Columbia and Nova Scotia that pay doctors based on the size of their patient roster, patients’ ages, and complexity of conditions. The longitudinal funding model also compensates for indirect clinical time.

The Manitoba model is also designed to give family doctors flexibility to continue to bill fees-for-service at the full rate, while receiving compensation based on their patient list.

The tentative agreement also introduces a new billing option for family doctors and pediatricians who see patients with more than one concern in a single visit.

“Changes like this are game changers,” Boroditsky said. “What they’re doing here is they’re trying to take away the focus from a physician to do volume-based care.

“At the end of the day, the more patients you see, the more volume you have, the better you can cover your costs,” he said. “And, unfortunately, that sometimes comes at the cost of time, and you can’t spend the time you need with the patients. And we feel that this model will help with that.”

The agreement also offers increased funding for specialty and hospital services; rural and northern retention and recruitment initiatives; and a permanent funding model for virtual visits.

Physicians will also receive a $21,000 practice stabilization support payment, if the agreement is ratified.

The payment is intended to cover costs incurred during the COVID-19 pandemic and was a commitment made by the Progressive Conservative government in its health human resources action plan.

Of the new funding, about $153 million is going to general rate increases, $50 million is going to family medicine, and $50 million is going to specialty and hospital care.

“By working together on a common vision with Doctors Manitoba, these unprecedented investments recognize the critical importance of our physicians and will maintain Manitoba’s competitiveness with other jurisdictions while improving access to the vital medical services physicians provide for all Manitobans,” Premier Heather Stefanson said in a news release.

Opposition NDP health critic Uzoma Asagwara said the new agreement will not reverse years of government austerity and the province’s massive physician shortage.

More than 400 doctors are needed in Manitoba to reach the national average, according to Doctors Manitoba; meanwhile, more than 40 per cent of working physicians plan to retire, leave Manitoba or reduce their workload.

“It’s no surprise Manitoba has the third-lowest number of doctors in the country under the PCs, after they cut millions from the rural doctor recruitment and retention fund and numerous doctors left the Brandon and Manitoba clinics,” Asagwara said.

A ratification decision by Doctors Manitoba membership is expected Aug. 14.

danielle.dasilva@freepress.mb.ca