January 14, 2020

The GPSC’s first Community Longitudinal Family Physician (CLFP) Payment will be paid to eligible family physicians on January 15, 2020 by MSP Teleplan. The January 15 MSP remittance statement was available to physicians as of January 13, 2020.

DOWNLOAD

FAQs about how the new
CLFP Payment works,
including eligiblity details.

The CLFP Payment will be paid to the payee number where GPSC Portal Code (G14070) was first submitted in 2019. The CLFP Payment is identified on the MSP remittance statement as Adjustment Code “CP”. This new CLFP Payment is not a retroactive payment. Retroactive payments are identified by adjustment code “80” .

CLFP Payments ranged from $3,000 to $12,000, with the majority of eligible physicians receiving $4,000 to $8,000. The exact payment amount for individual physicians is in the MSP remittance statement.

In introducing the CLFP Payment, the GPSC has taken another important step in supporting the vital contribution of longitudinal care to improve outcomes for patients and the health system. The annual, ongoing CLFP Payment recognizes community-based family physicians who provide relationship-based care to a panel of patients over time.

Eligible family physicians will receive 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.

When a physician submits G14070 it signifies that they are:

  • Providing full-service family practice services to their patients, and will continue to do so for the duration of that calendar year.
  • Confirming their doctor-patient relationship with their patients through a standardized conversation or the “family physician – patient compact.”

Family physicians who meet the requirements of GPSC Portal Code (G14070) should submit G14070 on an annual basis to ensure they are considered for future CLFP Payments. They are also encouraged to post the family physician – patient compact in their examination rooms and to have conversations with patients to confirm their-doctor-patient relationships. To read more about approaches to increasing relational continuity in your office, see here.

The CLFP payment may be subject to clinic-specific 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.

For questions or more information, contact gpsc.billing@doctorsofbc.ca.

PHYSICIAN QUESTIONS & ANSWERS

Updated January 14, 2020

WHAT HAPPENS IF I DID NOT SUBMIT THE GPSC PORTAL CODE (G14070)?

Physicians who did not submit GPSC Portal Code (G14070) in 2018 and in 2019 (prior to June 19, 2019) are not eligible to receive the 2019 CLFP Payment. Physicians who meet the billing requirements of G14070 should submit G14070 on an annual basis to ensure they are considered for future CLFP Payments.

WHAT DO I NEED TO DO TO PREPARE FOR NEXT YEAR’S PAYMENT?

The exact eligibility criteria for future CLFP Payments is currently being finalized. Watch for more information to follow. Physicians who meet the billing requirements of GPSC Portal Code (G14070) should submit G14070 on an annual basis to ensure they are considered for future CLFP Payments.

HOW WILL MY PAYMENT AMOUNT ACTUALLY BE DETERMINED?

Payment amounts for each eligible physician will vary according to the number and the complexity of Majority Source of Care (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.

WHAT DO YOU MEAN BY “CLINIC-SPECIFIC BUSINESS ARRANGEMENTS?”

The CLFP payment may be subject to clinic-specific business arrangements pertaining to how MSP Teleplan payments paid to particular “payee numbers” are split between physicians and clinic owners.

Depending on the agreements you have made at your work setting, your “practitioner/billing number” and your “payee number” may be one and the same. In other cases, physicians may make agreements at their work settings to have the billings they generate under their practitioner number go to a clinic payee number. The payee number tells MSP where to send payment for claims submitted under the practitioner number.

Generally, there are 4 basic models for workplace agreements about payment for clinic overhead:

1. MSP Teleplan payments for individual physician get deposited directly to physician’s own account. Thereafter:

  • physician pays clinic a fixed dollar amount, or,
  • physician pays clinic a percentage of their MSP Teleplan income.

2. MSP Teleplan payments for individual physician get deposited to clinic payee number account. Thereafter:

  • clinic pays the physician a percentage of the MSP Teleplan revenue generated by the physician, or,
  • clinic pays the physician an amount based on other clinic-specific agreement.

Each of these approaches may have different impacts for CLFP Payments. Physicians and clinic owners are encouraged to come to a mutual agreement on how existing business arrangements apply to the CLFP Payment.

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 longitudinal 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.

WHY WAS THE PAYMENT NOT MADE AVAILABLE TO PHYSICIANS ON ALTERNATIVE PAYMENT MODELS?

Recognizing that additional, non-clinical responsibilities required for providing longitudinal care are generally undervalued in fee-for-service, the CLFP Payment is designed to support community-based family physicians working under fee-for-service. Therefore, only FP services provided under fee-for-service are considered when determining eligibility and payment amounts for the CLFP Payment. A FP who provides services under fee-for-service and an alternative payment/funding model may receive payment if they meet the eligibility criteria of the CLFP Payment.

AS A LOCUM, AM I ELIGIBLE FOR THE PAYMENT?

To qualify for the CLFP Payment, a physician must have billed the GPSC Portal Code (G14070) and have 50 or more MSOC patients based on family physician visits provided under fee-for-service in previous calendar year. Physicians who do not meet these requirements, even if they have billed the GPSC Locum Portal Code (G14071), are not eligible for the 2019 CLFP Payment. A locum physician may discuss with host physician (if host physician is eligible for CLFP Payment) to come to an arrangement on how the CLFP Payment may be shared.

I AM COMPENSATED ON A POPULATION-BASED FUNDING MODEL. AM I ELIGIBLE FOR THE PAYMENT?

No. Unlike FFS, PBF funding remunerates physicians according to the size and complexity of their patient panels. As PBF funding is not directly tied to visit/procedure volume, PBF provides more flexibility for physicians in undertaking longer clinical visits and non-clinical activities without negatively impacting compensation. As such, PBF (relative to FFS) provides more reasonable and predictable compensation for the time-consuming aspects of longitudinal care.

The GPSC partners – the Ministry of Health and Doctors of BC – are currently in discussions to develop new alternative payment/funding models, including PBF contracts.

HOW DOES THE GPSC SUPPORT COMPREHENSIVE CARE OUTSIDE A 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.