Blended Capitation Model of payment in Alberta

[Kanata]

Hello all,

R1 in FM currently. I recently read some articles on the blended capitation model in Alberta. I also read details about the FHO models of Ontario. Both of these appear similar to me, e.g., both are capitation models, both pay for a number of patients rostered plus portion of FFS. A lot of people consider FHO models lucrative in terms of a business model. My question: Is the blended capitation model in Alberta the same as the FHO model? If yes then why don't people talk much about it online? and why is it that this model is not so popular in AB? Is it as lucrative as FHO?

Any insights will be helpful. Thanks.

[drake19]

On 4/15/2023 at 4:58 PM, Kanata said:

Hello all,

R1 in FM currently. I recently read some articles on the blended capitation model in Alberta. I also read details about the FHO models of Ontario. Both of these appear similar to me, e.g., both are capitation models, both pay for a number of patients rostered plus portion of FFS. A lot of people consider FHO models lucrative in terms of a business model. My question: Is the blended capitation model in Alberta the same as the FHO model? If yes then why don't people talk much about it online? and why is it that this model is not so popular in AB? Is it as lucrative as FHO?

Any insights will be helpful. Thanks.

currently fp in ontario not in fho

personally these were reasons why i didn't do fho:

at the end of the day i think if you did the same amount of work as a ffs or fho physician - the fho physician would pay more but fho were not too common/difficult to find when i first started - not sure how the landscape is now, also you need to build up a practice for enough capitation income, fho do have income stabilization though before they build up a roster

just from the fho physicians i've spoken to - they pay around 30% + HST for overhead- the hst alone can be pretty hefty

ffs physicians especially if linked to a pharmacy can pay much lower and have hst included - some pharmacies even cover the entire cost of over head 

biggest downside i think for ffs is you need high volume - you'll have to ask patients to followup if they ask for too many things at once 

fho is good i guess since you don't have to rely on volume compared to a ffs physician

fho physicians also have to worry about their outside use

from the facebook group for ontario gps someone mentioned (i'm assuming this is rare) that some physicians have a fho and just do ER/nursing home while they hire locum or NP to run most of their practice - so if you're running that type of model that can be lucrative for you but not ethical.

it all depends on your personal preference at end of day

 

[Kanata]

On 4/26/2023 at 6:04 AM, drake19 said:

 

just from the fho physicians i've spoken to - they pay around 30% + HST for overhead- the hst alone can be pretty hefty

ffs physicians especially if linked to a pharmacy can pay much lower and have hst included - some pharmacies even cover the entire cost of over head 

 

 

Please explain. How can a pharmacy cover the overhead for a medical clinic? I mean how is it done practically? Is it common? 

 

On 4/26/2023 at 6:04 AM, drake19 said:

 

from the facebook group for ontario gps someone mentioned (i'm assuming this is rare) that some physicians have a fho and just do ER/nursing home while they hire locum or NP to run most of their practice - so if you're running that type of model that can be lucrative for you but not ethical.

 

 

I have heard of this a few times. My question: If it is not ethical, how do physicians get away with it? 

On the other side, if the patients get medical services they need from another NPs or locums at the end of the day, what's wrong in it? Sorry, don't want to seem like I am favoring it, but just asking to get a better understanding. 

[usatocanada]

following

 

[drake19]

On 5/1/2023 at 3:08 PM, Kanata said:

Please explain. How can a pharmacy cover the overhead for a medical clinic? I mean how is it done practically? Is it common? 

 

I have heard of this a few times. My question: If it is not ethical, how do physicians get away with it? 

On the other side, if the patients get medical services they need from another NPs or locums at the end of the day, what's wrong in it? Sorry, don't want to seem like I am favoring it, but just asking to get a better understanding. 

For mom and pop stores that don’t get volume of say a shoppers they eat cost to run busy wic to attract pt. Ie I see about 50 on a sat morning and now cap at 80 on a weekday . If I wanted to and had the energy could see as many as I want since we are also situated beside condos and refugee shelter. So they get foot traffic from pt that may or may not use their pharmacy.

I guess it’s not ethical to profit without intending to be a family doctor for the fho. Also cannot shadow bill with np. Just my personal take not sure what the rules are