Changes to the FHO model are being implemented for April 1, 2026

To: All 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: April 1, 2026
Bulletin Number: 260308

Overview

The Ministry of Health and the Ontario Medical Association have been working together to implement a modernized Family Health Organization (FHO) model sometimes referred to as FHO+. In accordance with the 2024 Physician Services Agreement (PSA), several changes to the FHO model are being implemented effective April 1, 2026.

Hourly rate payments

Please see INFOBulletin 260309 — 2024 Physician Services Agreement – FHO Hourly Rate Payments for further details on hourly rate payments.

Blended Fee-For-Service premium increase

Effective April 1, 2026, the Blended Fee-For-Service premium will be increased from 19.41% to 30% for all in-basket (regular and long-term care) services to FHO physicians providing services to FHO enrolled patients on or after April 1, 2026.

Information regarding the further increase to the Blended Fee-For-Service premium from 30% to 50% for specific in-basket services will follow when available. The increase will be retroactive to April 1, 2026.

After-hours premium increase

Effective April 1, 2026, the after-hours premium for FHO physicians will increase from 30% to 50% on all relevant codes billed with a Q012.

Relevant FHO after-hours codes as of April 1, 2026: A001A, A003A, A004A, A007A, A008A, A888A, E089A, K005A, K013A, K017A, K030A, K033A, K130A, K131A, K132A, K133A, Q050A, Q888A.

Ending access bonus and outside use

Effective April 1, 2026, outside use and access bonus payments have ended for FHO physicians.

FHO physicians will continue to receive the "Outside Use Report (Patients with Signed Consent)" delivered via MCEDT for reference purposes; outside use deductions will not be generated.

Ending comprehensive care capitation

Effective April 1, 2026, comprehensive care capitation (CC cap) payments have ended for FHO physicians.

Reconciliation processing will remain available for 365 days until March 31, 2027, to support activities triggered by enrolment adjustments occurring within that period.

Assessment and reporting relating to CC cap payments will fully conclude as of March 31, 2027.

Enhanced Group Management Leadership Payment

Effective April 1, 2026, a new enhanced Group Management Leadership Payment (GMLP) will be provided in return for the group lead(s) providing leadership to ensure FHO contract compliance generally, including appropriate after-hours availability and care specifically as outlined in the FHO contract.

Enhanced GMLP (eGMLP) will be calculated as an administrative payment of four dollars ($4) per enrolled patient per fiscal year, prorated daily for each patient enrolled to the group, up to a maximum of $100,000 per group. In no event will the sum of the current GMLP and the new eGMLP be less than $25,000 per year per group.

Payment of the existing GMLP program will remain status quo; payment for the eGMLP will be issued monthly beginning with the May 2026 remittance advice (RA) under accounting transaction "Enhanced Group Management Leadership".

Keywords/Tags

Physician Services Agreement; PSA; physicians; FHO; Hourly Rate; Blended Fee-For-Service; After-Hours; Access Bonus; Comprehensive Care Capitation; Group Management Leadership Payment; GMLP

Contact information

Do you have questions about this INFOBulletin? Email the Service Support Contact Centre or call 1-800-262-6524. Hours of operation: 8:00 a.m. to 5:00 p.m. Eastern Monday to Friday, except holidays.