ALTERNATIVE PAYMENTS PROGRAMFUNDING APPLICATION

Introduction

The information provided in this application is intended to enable the Ministry of Health (the Ministry) to understand and properly compare and assess requests for new and/or expanded funding for physician services provided by contracted and/or salaried physicians.

This funding application process provides opportunities for health authorities to access funds for new or expanded physician services that are innovative and aligned with Ministry goals in the delivery of health care services to British Columbians. The application criteria developed to assess Alternative Payment Program (APP) funding requests are aligned with the strategic goals of the Ministry as described in the Ministry’s Service Plan, Government Letter of Expectations (GLE), Key Results Areas and the Office of the Controller General and Office of the Auditor General (OCG/OAG) requirements as well as APP policies and directives. The information submitted will form the basis for a new or revised funding agreement between the Ministry and the health authority/agency for applications approved under this process.

Applications will be reviewed and evaluated by an Evaluation Committee comprised of representatives from a cross section of Ministry divisions. The Evaluation Committee will develop prioritized recommendations within the available funding envelope for approval by the Ministry Executive Committee.

General Guidelines for Applicants

An application for APP funding must be sponsored by a British Columbia health authority or by another government agency recognized by the Ministry (e.g. Ministry of Children and Family Development, Solicitor General, etc.). Applications will be accepted for expansion of physician services currently provided through APP as well as for new physician services. If there are physicians currently providing the service, the health authority/agency will need to confirm that the physicians are aware of and supportive of the proposal. If the physicians are not aware or supportive, the health authority/agency needs to explain how this will be addressed.

Information provided in this application is intended to enable the Evaluation Committee to assess and rank each application received on a consistent basis using agreed upon evaluation criteria. All information provided in connection with this application is subject to verification, including MSP billing information (if applicable).

The volume of applications may result in an overall demand for APP funds that exceeds what is available. It is in the applicants’ best interest to ensure that the application provides a complete and comprehensive understanding of the service model being proposed and the reasons why APP funding is necessary. Applications must be consistent with the Physician Master Agreement (PMA), the Alternative Payments Subsidiary Agreement (pg 106 of the PMA) as negotiated and agreed to by the Government and BC Medical Association, as well as Ministry of Health policies and directives.

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Application Timelines and Processes

The Ministry will communicate a timeline for the Alternative Payments Program Funding Application process: The agency must submit an application to the Evaluation Committee using the Alternative Payments

Program Funding Application within the required timelines. If interpretation of the questions is required, please contact (HLTH.PhysicianComp@gov.bc.ca). The Evaluation Committee will review all applications received by the required dates and may seek

clarification from the applicants. The Evaluation Committee will determine the net new cost of each application by calculating the

difference between proposed costs and current costs. The Evaluation Committee will evaluate and rank all of the applications received and provide prioritized

recommendations to the Ministry Executive Committee for approval within the funding envelope available.

Once the Ministry Executive Committee has made APP funding commitment decisions for the fiscal year, the Ministry’s Evaluation Committee will provide written notification regarding each of the received applications. The written notice will specify the outcome of the Committee’s decision and any conditions specific to the funding. There will be an opportunity for a debriefing.

Successful applicants (agencies) will then enter into discussions with the Ministry of Health to confirm agreement on the terms and parameters of an APP funding contract that is consistent with the written endorsement provided by the Evaluation Committee, the Physician Master Agreement’s Alternative Payments Subsidiary Agreement and Ministry policies and directives.

Once the agency and Ministry have agreed upon the funding contract terms, conditions and parameters, the agency will then be empowered to conclude a service agreement with physicians within the terms, conditions and parameters of the agreed upon APP funding agreement.

Instructions for the Submission of Applications

1. Applications must have agency senior executive approval.2. Questions are provided to assist the agency communicate a clear, current and complete understanding

of the service proposal as well as why APP funding is necessary. 3. Additional material may be provided to the Evaluation Committee where the agency feels it would be

helpful for a clear understanding of an application. 4. The amount of space available after a question does not indicate the amount of information to be

provided. Applicants are responsible for ensuring that the Evaluation Committee has all the information it may require to make a fully informed assessment. Additional information may be attached (as a separate document) to the completed application form.

5. Do not leave any questions blank as it may disadvantage the application . State “N/A” if a topic is not applicable.

6. Completed applications are to be directed to: Physician Compensation Branch at the Ministry of Health, via secure file delivery service (APP contracts folder).

7. Upon submission of the application package, an email must be sent to notify Ministry staff that the application(s) was/were uploaded (HLTH.PhysicianComp@gov.bc.ca).

8. Each application will be acknowledged upon receipt by email. If you do not receive an acknowledgement email within 48 hours, please contact the Ministry of Health Physician Compensation Branch at (250) 952-3588.

If you cannot access the secure file delivery site, please contact the Physician Compensation Branch at: (250)952-3588.

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ALTERNATIVE PAYMENTS PROGRAM FUNDING APPLICATION FORM

APPLICANT INFORMATION

HEALTH AUTHORITY     

Date (YYYY / MM / DD)     

AUTHORIZED REPRESENTATIVE     

POSITION / TITLE      

TELEPHONE NUMBER(     )       -      

FAX NUMBER(     )       -      

EMAIL ADDRESS     

MAILING ADDRESS      

POSTAL CODE     

E MAIL     

FOR FURTHER INFORMATION CONTACT (NAME / POSITION / TITLE)

     TELEPHONE NUMBER (INCLUDE AREA CODE)(     )       -      

EMAIL ADDRESS     

APPLICATION APPROVAL FOR SUBMISSION By checking this box you affirm that you have health authority/agency senior executive approval and you

acknowledge that you take responsibility for the information provided in the same manner as if you had signed this form.

Name and Position/Title of the HA/Agency senior executive who approved this application:

     TELEPHONE NUMBER (INCLUDE AREA CODE)(     )       -      

EMAIL ADDRESS     

TITLE OF APP APPLICATION

     

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BACKGROUND / PROBLEM / OPPORTUNITY STATEMENT

1. Briefly describe the service, need, gap or redesign opportunity as well as the target populations addressed in the proposal.

     

CONTEXT/CURRENT SITUATION

2. Describe the history and context of the issues being addressed by the proposal. Identify what (if any) services (direct and indirect) are currently provided and the current level of coverage (e.g. hours; time of day; days per week; weeks per year).

     3. Include a brief description of the practices in other jurisdictions, including leading/best practices (how have other

jurisdictions delivered similar services).

     

ALTERNATIVES CONSIDERED

4. Briefly identify options that were considered as part of this proposal in the table below. Provide name, description and key pros and cons for each option.

Status Quo Option 1 Option 2

Description                 

Pros                 

Cons                 

Recommended OptionIdentify the recommended option, which the balance of the proposal will focus on. Provide the rationale for choosing the recommended option.

     

DESCRIPTION OF PROPOSAL

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5. Provide a complete description of the new / revised / expanded service that is being proposed to address the problem / opportunity. Describe the type and level of coverage of the physician services (e.g. types of patients; volume of patients; location(s)of service; hours; time of day; days of week; weeks per year; volume of patients; type of patients; etc.) that will be provided under the proposed service agreement. How will this differ from current coverage?

     6. How will this differ from current services? Specifically identify any new services that will be included in this proposed service

agreement.

     7. Identify the location(s) where these physician services are to be provided and indicate if any change in the existing location of

service is contemplated by this application.

     8. Describe the physician(s) capacity (experience, expertise, availability) to provide the services identified for the proposed

service agreement. If local physician(s) cannot fulfil the need immediately, what are the recruitment plans?

     9. What related services should be considered out of scope for the proposed service agreement? If these are billable to MSP

Fee-For-Service please identify the applicable specific fee codes.

     

ALIGNMENT WITH PRIORITIES & STRATEGIES

10. Describe how this proposal aligns with / supports / reinforces Government and health care priorities / strategies for the delivery of health care services in British Columbia; for example:

Ministry Service Plan priorities, Key Results Areas and strategic goals and priorities Government Letter of Expectation (GLE), goals and priorities. Health authority/agency operational priorities and service delivery plans

Provide information only where there is a solid alignment

Priority Area Alignment of This Initiative           

           

           

           

EXPECTED BENEFITS

11. Describe how the proposed service agreement will improve access to medical services by patients.

     12. Describe how the proposed service agreement will improve the quality of medical services to patients.

     

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13. Describe how the proposed service agreement will increase the quantity of medical services to patients.

     14. Describe if and how, the proposed service agreement incorporates Lean management principles and/or how it will improve

flexibility and efficiency in service delivery through a more comprehensive, team-based service delivery model (e.g. involvement of other health professionals) which will contribute to better use of the physicians’ time and expertise.

     15. Describe how the proposed service agreement will improve the capacity to recruit and/or retain physicians for the stability of

the proposed services.

     16. Describe how the proposed service agreement better facilitates the engagement of necessary physician services (e.g.

retention, quality of work and life, relationship between agency and physicians etc).

     17. Describe how the proposed service agreement will contribute to improvements in the management of physician services

(e.g. how will the proposed contract better coordinate and support the efficient use of physician services).

     

STAKEHOLDER CONSULTATION / CONSIDERATION

18. Identify the major stakeholder groups (internal business areas and external) who may influence or be impacted by the proposal, and whose interests must be considered. Provide a brief qualitative assessment of the initiative’s impact on the stakeholders. Examples may include changes to staffing, service delivery, systems, operating costs, etc. Determine whether the proposal is supported by the key stakeholders/partners prior to submitting for review. If it is not supported by a key stakeholder group, please explain the agency’s plans for addressing this issue.

(Where stakeholders are not applicable, please indicate N/A).

Stakeholder Impacts / RolesINTERNAL

Physician groups     

Other health care service providers     

Hospitals     

Residential Care facilities     

Other ( specify )      

EXTERNAL

Patients types / clients     

Communities / regions      

Ministry of Health – MSP / Pharma Care/ Finance Division/ Health Authorities Division – Government Letter of

     

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Expectations, service expectations/ etc.

Other Health Authorities - specify     

First Nations Health Authority     

Non-Governmental Organizations      

Other (specify)     

IMPLEMENTATION

19. Describe any and all changes that may be required in other existing health care services or plans to implement this proposal and how this change is to be transitioned.

     20. Describe what, if any, additional resources will be necessary for the health authority/agency to fully implement the proposed

service agreement (e.g. Operating funding, beds, facilities, capital equipment, other health care human resources such as other physicians, other health care professionals, support staff, IT systems, etc.). Are the additional resources in place? If not, can they be secured? How and when will they be secured?

     21. If the success of this application is dependent upon additional resources, support and/or the collaboration of organizations

external to the agency (e.g. other health authorities, agencies or government) or will impact upon their plans and operations, please identify those other organizations and the authorized individuals in those organizations who have formally confirmed their organization’s commitment to provide the necessary resources or collaboration agreements from their organization. Note: The Application will not be considered complete without such confirmation.

     22. Besides the above, briefly describe any other critical factors or activities required for ensuring the successful launch and

ongoing operation of the proposal.

     23. Identify timelines for full implementation (including recruitment where necessary).

     

MONITORING AND EVALUATION

24. Briefly describe the anticipated beneficial outcomes from the successful launch and operation of this proposal.

     25. Describe how performance will be monitored and measured, specifically: what are the targets and what data sources will be

used for measuring and monitoring planned success? Performance measures and targets should be established throughout a specified two to three year time period. These performance measures and targets will relate directly to Ministry and health authority/agency targets (e.g. Key Result Area, Service Plan, GLE measures).

     26. How frequently and in what format will the information be shared with the Ministry?

     

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27. What action will be taken for non-compliance and /or non-performance?

     

CURRENT FINANCIAL COSTS

28. If there are current costs associated with the physician services described in this proposal, identify these costs and the source of these figures:

AMOUNT SOURCE(a) MSP Payments

(FFS Billings only- includes existing APP contract where there is a FFS top-up)

           

(b) APP Payments (Service Contract / Sessions)            

(c) HA Operating Costs            

(d) Other            

Total Current Costs      *include all payments beyond MSP payments in cash or in kind made to the physician(s) by the Ministry or a health authority/agency under the proposed form of compensation (eg. global operating budget, sessions funding, etc.).

PROPOSED FINANCIAL COSTS

29. Proposed costs include the product of the number of full-time equivalents (FTEs) as proposed in the application and the placement on the appropriate Service Contract Range (refer to schedule B of the Alternative Payments Subsidiary Agreement - page 106 of the PMA), and all additional public costs.

Hours of Service per FTE (Service agreements) Practice Category (Service agreements)

           

Other Funding Contributions (e.g. MSP Billings, APP Sessional Funding etc)

Amount$     

           

           

           

Total Additional Costs: $     

Total Proposed Cost of Service Agreement:(Gross Physician Cost – Total Additional Costs)

$     

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Number of FTEs / Sessions

Payment per FTE (position on range) Gross Physician Cost(FTE x Payment Per FTE)

      $      $     

30. Additional Costs – Provide a high-level, order-of-magnitude estimate of any other additional annual costs for the services under the proposed service agreement (provide details). Include a summary of any other additional costs associated with this proposal (e.g. staff salaries, equipment, operating costs, capital costs etc.).

     

OTHER FINANCIAL IMPLICATIONS

31. Indicate any upstream/downstream financial impacts that could affect other health service organizations.

     32. Describe any associated cost savings (e.g. MSP fee-for-service recoveries, NITAOP travel costs) or cost avoidance (e.g.

reduced ER visits).

     33. Provide any additional comments or information which clarify the financial implications.

     

PHYSICIAN INFORMATION

34. If available, please provide name(s) and MSP practitioner number of participating physicians:

Name of Physician MSP Practitioner Number                                                                             

ADDITIONAL INFORMATION

35. Please provide any other information that you believe will enable the Evaluation Committee to assess this application on a fully informed basis.

     

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