Saskatchewan to adjust payment model for family physicians

Change is coming to the payment model for Saskatchewan’s family physicians.

On Friday, the provincial government announced plans to alter the family physician compensation model, saying it would be based on what the government called “blended capitation.”

It will offer two streams of pay: A base payment for a standard list of services for each patient (like a per-capita payment), with the amount adjusted by the age, gender and complexity of each patient’s needs; and, an additional fee-for-service payment for extra services provided outside of the defined list of services.

The plan is an alternative to the traditional fee-for-service model, under which a doctor is paid on the quantity of services provided.

The government said the change was considered after it heard concerns about the fee-for-service model from the Saskatchewan Medical Association (SMA).

Doctors are happy that the government listened.

“We’re thrilled. We were really excited to hear that this was something government was coming forward with. It’s something that we’ve been asking for a period of time now, so we were really heartened to hear that they had heard us,” said Dr. Carla Holinaty, a family physician in Saskatoon.

Holinaty said she feels the new model will not only help physicians, but patients as well.

“We’ve been working really, really hard to try and get these changes that make the system better for patients, so we want to do what’s right by our patients and I think we’re excited to be able to hopefully change things so we can continue doing that in the long term,” she said.

“We are excited to be pursuing a compensation model that supports family physician-led team-based care and a more sustainable health-care system in Saskatchewan,” Health Minister Paul Merriman said in a media release.

“We take the concerns and needs of our patients and family physicians very seriously and look forward to seeing this work advance.”

“This is very positive news for patients and physicians,” added outgoing SMA president Dr. John Gjevre. “Family physicians are reassured to know that the government has heard their concerns and is moving forward with solutions that demonstrate they are a willing partner in addressing the challenges in our health-care system.”

Gjevre said the COVID-19 pandemic helped shine a light on some of the weaknesses in the health-care system.

“It’s been a very difficult time in health care the last two or three years, and that may have helped accelerate some of the changes,” he said.

“The system has been fairly static since the 1960s, and heck, it’s the 21st century. We need to innovate. We need to have a new model that works in today’s realities.”

According to the government, the model was recommended by a collaborative working group comprising representatives of the SMA, the Saskatchewan Health Authority and the Ministry of Health.

“The new payment model will take time to design through further group effort,” the government’s release said. “In the meantime, the ministry intends to work closely with the SMA to design transitional measures that build capacity for physicians to eventually adopt blended capitation.”

There were conversations that it could take up to 12 months for a deal to be completed, and Holinaty said she would like to see it done sooner.

“We know that there’s a lot of stress on our family doctors. We know that there are people making decisions about their practices and whether they’re staying in family medicine or moving on to other things,” she said.

Rural and Remote Health Minister Everett Hindley said the government wants to get a deal completed soon, but needs to make sure it’s done right.

“I’m hopeful that as we work through this, and work through it as quickly as we can in partnership with the SHA, that we’re able to do that and make some positive changes,” the minister said.

Hindley also said the government is currently working on expanding the hospital capacity dashboard into Regina and other regional centres.

The government said it hopes the change will help with the recruitment and retention of family doctors in the province. The government said over the past 20 months, 72 family doctors and 106 specialists have come to Saskatchewan from outside the province.

— With files from 650 CKOM’s Steve Seto