N.S. to pilot new doctor payment model aimed at recruitment, retention

A pilot project by the Nova Scotia government will pay family doctors based on how many patients they have and the number of services they provide.

Doctors Nova Scotia and the province worked together to develop the new funding model -- blended capitation -- which will be piloted at several family practices.

"With an aging, sicker population, patient care today is much more complex and billing codes haven’t evolved to accurately reflect the work physicians do,” said the president of Doctors Nova Scotia, Dr. Leisha Hawker, in a news release from the province.

“This pilot project will test and inform a new payment model, which intends to make it easier for family doctors to provide the care their patients need."

Under the pilot, the province says physicians may also get a bonus for making sure patients receive timely access to care.

Currently, family doctors are paid using a fee-for-service model or by contract.

A 2019 “Master Agreement” between the province and Doctors Nova Scotia provides $7.3 million to pay physicians in the blended capitation pilot program.

The province says the new funding model will be piloted immediately at practices in Cheticamp, New Minas and Upper Tantallon. Other practices may be added to the pilot in the coming weeks.

Health and Wellness Minister Michelle Thompson says competitive pay is crucial in recruiting and keeping doctors in the province.

“This funding model aims to better support family physicians and improve patients’ access to care,” said Thompson.

Opposition parties are criticizing the plan, saying the PCs were elected on a promise to fix the healthcare system and say it’s not getting better.

“When we look at healthcare success, it’s gotten worse since they came into office,” said Liberal health critic Kelly Reagan. “They didn’t have a plan and it’s just getting worse.”

This model is not a new way of paying physicians. New Brunswick has already introduced it.

The NDP says instead of waiting for the results of a pilot project, the model should be adopted immediately.

“We already know it works in other places and so let’s just implement it,” said NDP health critic Susan LeBlanc. “We don’t have time to sit around and try things in little bits and pieces. We have to do a massive shift.”

The province says, under the new model, doctors in a clinic will work together to care for the practice’s patients, so if one physician is unavailable, another will fill in.

The government says this could mean more appointments would be available the same or next day, in the evenings and on weekends.

The pilot project is expected to run until at least March 2023. While participating doctors will keep getting paid using their existing payment model, they will get a top-up if they earned more under the new model.