N.L. paying telehealth company more than twice what it pays doctors for consultations
The association representing doctors in Newfoundland and Labrador is looking for answers after it discovered the province agreed to pay a private telemedicine company more than double what it pays family doctors for consultations.
The Newfoundland and Labrador Medical Association found a contract between the provincial government and Fonemed among the province's online roster of completed access to information requests. The five-year contract, which began March 1, is worth over $31 million and pays between $82 and $92 for virtual care appointments with nurse practitioners.
Meanwhile, the province pays family doctors about $37 for a standard in-person visit and $47 for a virtual care visit, with a cap of 40 virtual appointments per day, the medical association said in a letter to its members about the contract.
"Like Fonemed, a family doctor's clinic also operates as private businesses with their own staff, equipment and overhead," association president Dr. Kris Luscombe wrote in the letter dated Tuesday, adding: "Family physicians in the province are already feeling overstretched and undervalued, so we will continue to seek an explanation from government of the large discrepancy between physician rates and what is being paid for non-physician virtual care."
St. John's-based Fonemed runs the province's 811 HealthLine, which connects residents with nurse practitioners who provide health advice. The contract renewed the company's previous service for the HealthLine.
Though the contract does not explicitly list the company's cost per call to the 811 line, it does specify that it covers up to 72,000 calls a year.
Using the monthly payments to the company specified in the contract, the medical association calculated that the cost works out to just over $82 per call in the first year of the contract. That cost increases each year to over $92 in the final year of the contract.
If the 811 service receives more than 72,000 calls in a year, the province will pay between $58.70 and $66.10 for each additional call, the contract specifies.
In his letter, Luscombe writes that the figures are "certainly surprising," given the rates paid to family doctors.
Newfoundland and Labrador has a population of about 525,000, and nearly a quarter of residents are without a family doctor, according to polling done this year by the medical association. Doctor shortages prompted intermittent closures of rural emergency rooms through the summer and fall.
The provincial Health Department said in an email Wednesday that the fees paid to Fonemed "reflect the overall costs to provide the virtual services," including overhead, infrastructure and technology costs, staff education, a 24-hour mental health crisis line and costs related to the HealthLine app.
The money also provides for virtual appointments with registered dietitians three days a week, as well as an outbound call service for people who left emergency departments without being seen by a physician or nurse practitioner, the email said.
The medical association noted in an email Tuesday that doctors also pay for all of their practice's overhead, infrastructure and staff costs through the money they collect -- including the $37 for an in-person visit -- through the province's fee-for-service payment structure.
On average, physicians spend roughly a third of their income on overhead costs, according to a 2018 report on family medicine in the province. That works out to about $82,496 in expenses each year, though in rural areas those costs can exceed $94,500, the report says.
The medical association said it is still seeking further explanation from the provincial government about why Fonemed is paid so much more than doctors for taking calls.
This report by The Canadian Press was first published Dec. 8, 2022.
CTVNews.ca Top Stories
Stormy Daniels describes meeting Trump during occasionally graphic testimony in hush money trial
Stormy Daniels took the witness stand Tuesday at Donald Trump's hush money trial, describing for jurors a sexual encounter the porn actor says she had with him in 2006 that resulted in her being paid off to keep silent during the presidential race 10 years later.
Former homicide detective explains how police will investigate shooting outside Drake's Bridle Path mansion
Footage from dozens of security cameras in the area of Drake’s Bridle Path mansion could be the key to identifying the suspect responsible for shooting and seriously injuring a security guard outside the rapper’s sprawling home early Tuesday morning, a former Toronto homicide detective says.
Jeremy Skibicki has 'uphill battle' to prove he's not criminally responsible in Winnipeg killings: legal analysts
Accused killer Jeremy Skibicki could have a challenging time convincing a judge that he is not criminally responsible for the deaths of four Indigenous women, a legal analyst says.
Bye-bye bag fee: Calgary repeals single-use bylaw
A Calgary bylaw requiring businesses to charge a minimum bag fee and only provide single-use items when requested has officially been tossed.
Air France flight from Paris to Seattle lands in Iqaluit after heat smell in cabin
A plane travelling from Paris to Seattle was forced to make an emergency landing in Iqaluit after there was a heat smell in the cabin during the flight.
CFL suspends Argos QB Chad Kelly at least nine games following investigation
The CFL suspended Toronto Argonauts quarterback Chad Kelly for at least nine regular-season games Tuesday following its investigation into a lawsuit filed by a former strength-and-conditioning coach against both the player and club.
Boy Scouts of America changing name for first time in 114 years, aiming for inclusivity
The Boy Scouts of America is changing its name for the first time in its 114-year history and will become Scouting America. It's a significant shift as the organization emerges from bankruptcy following a flood of sexual abuse claims and seeks to focus on inclusion.
Alcohol believed to be a factor in boating incident after 2 men die: N.S. RCMP
Two Nova Scotia men are dead after a boat they were travelling in sank in the Annapolis River in Granville Centre, N.S., on Monday.
Security guard shot, critically injured outside of Drake's Toronto mansion
A security guard working at Drake’s Bridle Path mansion in Toronto was seriously injured in a shooting outside the residence early Tuesday morning, police said.