In early 2023, British Columbia introduced the Longitudinal Family Physician (LFP) payment model, signaling a significant stride in addressing the challenges faced by family physicians. Over 3,600 family physicians have eagerly embraced this transformative model, which is a collaborative effort between the Ministry of Health, Doctors of BC, BC Family Doctors, and practicing family physicians.
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Unpacking the BC Family Doctors Payment Model (LFP)
The BC Family Doctors Payment Model LFP stands out by fulfilling a range of primary care providers’ needs, including:
- Quality Time with Patients: Ensuring family physicians have adequate time for patient interactions.
- Compensation for Indirect Care/Admin: Recognizing the time spent on administrative tasks crucial for patient care.
- Equitable Compensation: Addressing the longstanding issue of fair and comprehensive compensation.
- Recognition for Complex Patient Care: Acknowledging the challenges involved in managing complex cases.
- Physician Autonomy and Flexibility: Granting greater control over their practice.
- Support for Business Costs: Recognizing and addressing the rising costs associated with running a medical practice.
LFP Payment Model Structure
Unlike traditional fee-for-service models, the LFP payment model is a blended approach that combines three core components:
- Billing for Time: Including direct patient care, indirect patient care, and clinical administration.
- Billing for Patient Interactions: Covering various forms of interactions such as in-person, virtual, and home visits.
- Payment for Panel Size/Complexity: Providing compensation based on the number and complexity of patients in the physician’s care.
Notably, the LFP model streamlines medical billing with a concise set of fee codes, simplifying the overall process.
LFP Payment Model Eligibility Criteria
To qualify for the LFP payment model, family physicians must meet specific criteria:
- Maintain a minimum panel of 250 active patients.
- Provide both in-person and virtual longitudinal family medicine care.
- Deliver the required services outlined in the LFP Payment Schedule.
- Practice a minimum of one day per week, distributed equitably over the year.
- Limit non-panel patient services to a maximum of 30%.
Understanding how the LFP model compensates physicians is crucial for informed decision-making. A compensation calculator provided by BC Family Doctors aids in comparing the LFP model against existing payment models.
Billing for Time
Physician time is compensated at a rate of $32.50 per 15-minute period, covering direct patient care, indirect patient care, and clinical administration. The model simplifies billing with just three time codes, tailored for permanent and locum LFP physicians.
The model emphasizes simplicity, billing time codes with a specific diagnosis (ICD-9) regardless of the actual patient diagnosis.
Billing for Interactions
Eight codes complement time-based billing, covering various patient interactions, such as in-person clinic visits, virtual interactions, consultations, and group interactions.
The model allows flexibility in choosing the most relevant interaction code for each visit, avoiding complex thresholds.
Family physicians enrolled in the LFP model receive an annual panel payment based on the number and complexity of active panel patients. The CLFP methodology is applied for the year 2023, with ongoing updates to ensure accurate compensation.
LFP Payment Model Enrollment Process
Enrolling in the LFP model involves obtaining a facility number for the LFP clinic and submitting the Registration Code 98000 to HIBC via Teleplan. Physicians can voluntarily withdraw from the LFP payment model, but re-enrollment is restricted for 12 months unless approved in writing by the Medical Services Commission.
Frequently Asked Questions
Who can be billed under the LFP model?
Billing is allowed for patients on the panel or those of other family physicians in the LFP clinic. Maternity services for non-panel patients are also billable.
Can I bill for work done by other clinicians?
No, the LFP model currently covers only physician work and time. Billing for the work or time of other professionals is not allowed.
How do I bill for time spent on-call?
Time spent on-call is billable if calls or patient visits occur during that time. The accumulation of time units applies to on-call scenarios.
The LFP payment model represents a revolutionary step in reshaping how family physicians in British Columbia are compensated. Familiarizing yourself with the intricacies of this model and leveraging its simplicity in billing can lead to optimized revenue for your family practice. For further information, refer to the provided resources, including the LFP Payment Schedule,Ministry of Health, Doctors of BC, BC Family Doctors.