Letter of Understanding: Alternative Payments Program funding

​As you may be aware, concurrent with the recent signing of the 2014 Physician Master Agreement (PMA), a Letter of Understanding (LOU) was signed between the Government and the Doctors of BC (DBC) to “…address the impact of increased service demand on physicians presently working under those Alternative Payment Arrangements”.  More simply stated, this LOU provides some funding to Health Authorities to add additional physician services to existing alternative payment contracts in response to workload issues.

A copy of the LOU is available: MoH ​Letter of Understanding Alternative Payments Program Funding

The key features of the LOU are as follows:

  • Funding to all Health Authorities is $10 million for fiscal 2015/16 and an additional $10 million for fiscal 2016/17 with the prospect of further funding in 2017 and 2018.  The funding will be allocated by the Ministry of Health to each Health Authority (HA) in an amount proportionate to each HA’s current annual expenditure on AP Arrangements.

  • The HA is responsible for the allocation of their share of this funding.  Total available for all of VCH, including PHC, for fiscal year 2015/2016 is expected to be approximately $2.9 million.

  • HAs may not use these funds to offset current expenditures on Alternative Payment Arrangements

  • There is no express application process required but the medical staff leadership in each Health Authority is to engage with and consider the views of physicians or physician groups presently working under Alternative Payment Arrangements.  In VCH the decision making process for allocation of funding will be under the auspices of the Executive Medical Group (EMG) which is composed of the Senior Medical Directors of each of the VCH Communities of Care, the VP Medical Affairs for PHC, and chaired by the VP of Medicine, Quality & Safety for VCH,  Dr Patrick O’Connor.  The allocation decisions will be informed by  internally available data, HA priorities and any submissions received by physicians.

Submission & Evaluation Process

Any physician or physician group who wishes to make a submission for consideration in the allocation of funding can do so by sending the submission to ​physiciancontracts@vch.ca no later than February 27, 2015.

There is no prescribed form but you will want to ensure any submission  directly addresses the applicable evaluation criteria set out in the next section and specifically identifies the requested increase in Full-Time-Equivalents (FTE) based on the current definition in the case of a Service Contract submission.  We understand that the Doctors of BC have developed a submission template for physicians to use. The use of this template is discretionary though it will be accepted as a submission. 

Criteria for Allocation of Fundin​g

Demonstrated increases in volume (recent data and/or longitudinal data since contract inception or since contract funding was last adjusted) by data such as:

  • Decision support data on service volume trends, services provided, RIW, etc.

  • Hours and encounter reporting data.

Supports/aligns with MoH Measures for Pay for Performance and/or other accepted objective metrics such as: 

  • ED admits within 10 hours

  • 52 week surgical waits

  • Hip Fracture Fixations within 48 hours

  • Care Sensitive Adverse Events

  • HCRS Assessments (Home Care Reporting System)

  • CCRS Assessments (Continuing Care Reporting System)

  • LLOS- Discharged (DAD, ADTC)

Aligns with one or more Ministry of Health Strategic Priorities

  • Provide Patient Centred Care

  • Prevention and Health Promotion

  • Primary and Community Care

  • Improve Access to Specialist Services

  • Access to Quality Diagnostic Services

  • Access to Clinically and Cost-Effective Pharmaceuticals

  • Review and Improve Acute Care Services

  • Appropriate Residential Care

Please contact either Ken Harman at Providence (kharman@providencehealth.bc.ca (604) 806-8012) or Christine Pietrzyk at VCH (christine.pietrzyk@vch.ca (604) 875-4278) if you have specific questions related to the above.

*  In case of group Service Contracts where there is a designated individual for receipt of notices, this Memorandum may be distributed to that individual rather than each physician in the group.​