Notice: Effective immediately, the Ministry of Health has temporarily suspended acceptance of all mailed/couriered documents and faxes related to application-based programs. Only applications that are sent by email to a ministry-designated account will be accepted. Applications that include electronic signatures (such as, scanned original, electronic device applications, or digital) will be accepted in lieu of original, signed documents.
Please refer to INFOBulletin 11233 for additional details on impacted programs and the designated ministry email account.

Overview

Primary care is the first point of contact between a patient and the health care system and includes:

  • illness prevention
  • health promotion
  • diagnosis
  • treatment
  • rehabilitation
  • counselling

In Ontario, primary care has evolved from a predominantly fee-for-service (FFS) system of independent physicians to more advanced group-based practices premised on patient enrolment and comprehensive care.

The different agreements address the needs of the general population as well as specific communities and populations with focused health needs while providing primary care physicians with many options.

Enhanced Fee-For-Service models

The Comprehensive Care Model and Family Health Group model physicians are compensated primarily through FFS but are also eligible for specific bonuses and premiums based on patient enrolment.

Comprehensive Care Model (CCM) is for solo physicians who commit to provide comprehensive primary health care and a block of after-hours services each week to their enrolled patients.

Family Health Group (FHG) is offered to groups of three or more physicians to provide comprehensive primary health care and after-hours services to their enrolled/assigned patients.

Currently active Family Health Groups

Capitation based models

Family Health Network (FHN) and Family Health Organization (FHO) models, which have six or more physicians, are compensated primarily through capitation payments but also receive FFS payments. The physicians are also eligible for specific bonuses and premiums based on patient enrolment.

The two models offer comprehensive care during a combination of regular physician office hours and after-hours services. Information technology and preventive health care services, chronic disease management and health promotion are also integral parts of these models. The key differences between the FHO compared to the FHN include the base rate payment, associated basket of core services, and access bonus calculation.

Currently active Family Health Networks

Currently active Family Health Organizations

Specialized models

There are a number of patient enrolment models that have been developed, targeting distinct population groups or geographical areas:

  • GP Focused Practice: Alternative Funding Plans for focused practice general practitioners in HIV, palliative care, and care of the elderly.
  • Toronto Palliative Care Associates (TPCA): developed to provide improved access for palliative patients to palliative care doctors and palliative care services in health centres, long-term care homes and in the home for Toronto area patients.
  • Homeless Shelter Agreements: provides primary health care services to homeless populations in Toronto (Inner City Health Associates), Hamilton/Niagara (Shelter Health Network), and Waterloo (Waterloo Region Inner City Physician Group).

There are also additional Specialized Models in Northern Ontario:

  • Rural Northern Physician Group Agreement (RNPGA): First offered in 1996 to groups of physicians in a rural community with 1 to 7 physicians. This blended capitation payment model provides a broad range of core primary health care services to all residents of a community (defined geographic area). There are 38 groups serving over 100,000 patients in the catchment areas of these rural and northern Ontario communities.
  • Group Health Centre: a long-standing interdisciplinary practice that serves 80% of the population in Sault Ste. Marie.
  • First Nations Agreements: Weeneebayko Area Health Authority and Sioux Lookout Regional Physicians’ Services Inc. developed for the provision of comprehensive primary care physician services, as well as secondary medical services to a population of 12,000 people, mainly First Nations communities, along James Bay Coast and part of the Hudson Bay Coastal area, as well as improving access to comprehensive primary care services to the 28 remote First Nations (FN) communities in the Sioux Lookout Region and the town of Sioux Lookout.

For additional information about one of these Northern Specialized Models, call: 1-866-727-9959.

Contact us

For additional information regarding any of the models, please reach out by email.