Monday, May 07, 2012
Ministry of Health and Long-Term Care
McGuinty Government Updating OHIP Fees To Improve Patient Care
Ontario is moving toward a real wage freeze for doctors in order to invest more precious health care dollars in community care for families and home care for its many seniors.
Patients will get better, frontline patient care including more community care nurses, expanded home care services for at least 90,000 seniors, and 1,100 more doctors as the province updates fees paid to physicians for services under the $11-billion Ontario Health Insurance Plan (OHIP).
Ontario's doctors are the best paid in the country, with the average doctor billing $385,000 and many specialists billing twice that much.
The government is updating and rebalancing OHIP fees to better reflect current medical practices and new technologies and to avoid double-payments. Best practices demonstrate that doctors are now often able to work more quickly and more effectively yet many fees have not changed to reflect these advances. Among the fee changes are:
The combined changes, effective as of April 1, 2012, are expected to result in savings of $338.3 million in 2012-13, allowing the government to invest in more home care and expanded health care services. The government will continue to negotiate with doctors to improve access to patient care, including same day/next day appointments and after-hours care to reduce pressure on emergency rooms.
- The province currently spends $88 million on self-referrals - the practice of referring a patient back to a doctor's own practice for an additional procedure and, consequently, additional billing. The payment for certain diagnostic tests such as X-rays and ultrasounds will be reduced by half when the same physician orders and performs the test.
- New technology has greatly reduced the time needed for 250 diagnostic radiology tests including X-rays, CT/MRI scans and ultrasound. To reflect this, fees paid for these tests will be reduced by 11 per cent over four years.
- New technology has reduced the time needed to perform cataract surgery from two hours to as little as 15 minutes. Fees paid to doctors for this procedure will be reduced from $441 to $397.75.
- The time taken to perform eye injections for retinal diseases now takes five to 30 minutes, down from two hours a decade ago. The fee paid to doctors for this service will be reduced from $189 to $90 over four years.
- Evidence shows that echocardiograms before routine non-cardiac surgery do not improve patient outcomes. Doctors will perform fewer of these tests.
- Best practices for CT scans and MRIs for lower back pain reveal that more targeted use of diagnostic tools helps to better support those patients with serious medical conditions such as infections or cancer and leads to earlier treatment for those patients with less serious symptoms by eliminating unnecessary diagnostic tests.
- To ensure more timely access to care, a new fee will be added for doctors to consult with each other through secure email.
Improving patient care by getting better value for our health care dollars is part of the McGuinty government's Action Plan for Health Care and builds upon the gains made in health care since 2003.
"Our doctors are the best paid in Canada. Instead of another raise for doctors, we need a real wage freeze so we can invest in more home care. To hold the line on doctor pay, we're making changes to fees for physician services to reflect advances in technology and the latest medical evidence on what helps patients most."
- Deb Matthews, Minister of Health and Long-Term Care
- 93 per cent of Ontarians now have access to a family doctor.
- The average doctor in Ontario bills $385,000 - 75 per cent more than in 2003 and ten times what the average Ontarian earns.
- Many specialists bill twice that amount and over 400 Ontario doctors now earn more than $1 million a year.
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