With the expiry of the Ontario Physician Services Agreement (PSA) in 2024, negotiations between the Ontario Medical Association (OMA) and the Ministry of Health (MOH) have been underway. The proposed FHO+ model is now in arbitration, with a decision expected this fall.
If you’re practicing in a Family Health Organization (FHO) today—or considering joining one—it’s important to understand how the proposed FHO+ model may affect how you work and how you’re paid.
What is the FHO+ Model?
FHO+ builds on the existing Family Health Organization framework. The idea is not to replace FHOs, but to modernize them. The new model aims to better reflect the scope of work family physicians perform every day, including time spent outside the exam room.
Charting, reviewing labs, managing rosters, and other administrative activities are critical to patient care but have often gone uncompensated. The FHO+ model aims to address this gap.
Key Highlights of the Proposal
- Access Bonus Removal: The access bonus would be eliminated, with those funds reallocated through time-based payments and higher shadow billing rates.
- Hourly Compensation: New $80/hour payments (in 15-minute increments, capped at 14 hours/day) would apply to direct care, phone consultations, administrative work, and roster management.
- Increased In-Basket Payments: Most codes rise to 30% of FFS, with some procedures moving to 50%.
- After-Hours Premiums: Compensation for extended hours would increase from 30% to 50%.
- Stronger Patient Rostering Incentives: Bonuses increase significantly for both established physicians and new graduates.
- Simplified Group Formation: The minimum requirement would drop from three to two physicians, with expanded flexibility around co-location distances.
Impact of the FHO+ Model on Your Practice
The FHO+ model recognizes that patient care extends well beyond the visit. For physicians, this means:
- More Fair Compensation: Time spent on administrative and indirect care tasks would now be recognized and paid.
- Revenue Growth Without Workflow Change: Shadow billing increases and new hourly payments represent natural revenue gains for work you already do.
- Improved Flexibility: Adjustments to rostering and group formation rules could make it easier to start or expand an FHO.
The OSCAR Pro Perspective
For practices using OSCAR Pro, these proposed changes highlight the importance of efficient documentation and accurate record-keeping. The move toward time-based billing and increased administrative recognition makes your EMR an even more critical part of how you track, document, and manage your day-to-day work.
With tools like customizable workflows, integrated reporting, and AI-driven supports such as Nexus AI™, OSCAR Pro can help ensure that the work you do—both clinical and administrative—is captured efficiently and accurately.
Looking Ahead
While the arbitration ruling is expected this fall, it’s clear that the FHO+ model represents a shift toward more comprehensive recognition of the work family physicians do every day. By compensating both direct and indirect care, it aims to make family practice more sustainable while improving patient care.
At OSCAR Pro, we’ll continue to keep you informed on what this means for your practice and how our tools can help you adapt to and maximize the benefits of these upcoming changes.
Disclaimer: This blog is based on the proposed FHO+ model as presented during PSA negotiations. Details may change pending the final arbitration ruling expected fall 2025. Please consult with the OMA and your billing advisors for the most current information.