Bulletin 240502 — Acuity Modifier Payment for the 2024–2025 Fiscal Year
An interim Acuity Modifier payment will be made for eligible FHN and FHO physicians for the fiscal year 2024-2025.
To: Family Health Network (FHN) and Family Health Organization (FHO) Physicians
Category: Primary Health Care Services
Written by: Physician Relations and Contract Oversight Branch, Physician and Provider Services Division
Date issued: May 6, 2024
Bulletin Number: 240502
Overview
The Ministry of Health (ministry) and the Ontario Medical Association (OMA) have been working together to introduce an Acuity Modifier into the capitation system for Family Health Network (FHN) and Family Health Organization (FHO) models as directed by the 2021 Physician Services Agreement, negotiated and ratified by the OMA and the ministry.
The new acuity modifier being introduced to the current capitation system is based on the Canadian Institute for Health Information (CIHI) Population Grouper methodology and will work to improve equity in FHN and FHO physician compensation for complex patient care. It will come into effect on April 1, 2024.
No action is required on the part of the physician/physician groups.
Acuity Payment for fiscal year 2024-2025
All FHN and FHO physicians who practiced in fiscal year 2022-2023 will receive the new one-time acuity payment as a lump sum payment on the May 2024 Remittance Advice in addition to their regular capitation amount.
This one-time payment for the entire fiscal year 2024-25 will appear under accounting transaction ‘PCA3 – NETWORK BASE RATE ACUITY MODIFIER PAYMENT’.
FHN and FHO physicians who started their practice in fiscal year 2023-2024 or will start their practice in fiscal 2024-2025 will receive their one-time new acuity payment for 2024-2025 as soon as practicable in the fall of 2025.
Acuity Payment for fiscal year 2025-2026 and beyond
Starting on April 1, 2025, acuity payments will be automated into the capitation system and will be included as part of all FHN and FHO physician monthly capitation payments on their monthly Remittance Advices. More details will be provided closer to the implementation date.
As a reminder, no action is required on the part of the physician/physician groups.
Overview of new Acuity Payment timelines
| Anticipated interim payment date | Physician cohort | Physician payment | Repurposed fund |
|---|---|---|---|
| After April 1, 2024 | Started practice prior to April 1, 2023 | One-time interim payment for service provided from April 1, 2024, to March 31, 2025 | Preventive Care bonuses |
| After June 1, 2025 | Started practice after April 1, 2023 | One-time interim payment for service provided from April 1, 2024, to March 31, 2025 | Preventive Care bonuses |
| To be determined | All physicians | Permanent, ongoing automated monthly payment after April 1, 2025 | Preventive Care bonuses and changes to the maximum fee-for-service pooling from groups to individual physicians (hard cap) |
Keywords/Tags
FHN; FHO; 2021 PSA; Capitation; Acuity Modifier
Contact information
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