In the past decade, Canada has had a doctor shortage. Doctor appointments are difficult to get and expensive to cancel. Specialist appointments need to be booked weeks or even months in advance.

Since 2023, the doctor to patient ratio in Canada has been around 246 to 100,000 patients, and the ratio grows even farther in the more remote parts of the country. The situation has left many Canadians clamoring for a change in the system.

The situation has grown dire indeed, which is why Canadian provinces have taken the necessary steps to alleviate these concerns. The Ontario government has taken some steps in the right direction by proposing a new compensation model for doctors working in FHOs (Family Health Organizations) with the sole intent of drawing more physicians to the province and retaining the physicians that are already employed there.

New deal to the compensation model - for doctors working in FHO ( Family Health Organizations) ( this may be a good place to add the link for the article)

What is FHO?

The FHO is Ontario's Primary Care Renewal program. It works on a Capitation Payment model which is a monthly payment that is paid to the doctor based on their commitment to provide comprehensive care to enrolled patients.

What is the New Compensation model?

The new model being proposed is called FHO+, and would potentially impact over 6,500 family physicians. The model will allow doctors to charge for administrative tasks and also includes new features such as new billing systems and increased after-hours premiums.

Why is Ontario setting up a new FHO model?

The new model was proposed in response to doctor concerns about unpaid hours spent on administrative tasks such as reviewing test results, and filling out forms and charts.

The new proposal was sent to arbitration on June 30^th 2025, and a ruling is expected in the coming fall. According to OMA CEO Kimberly Moran, the deal is around 90% and should it be finalized, the new model will take effect in the April of 2026.

What is the difference between FHO and FHO+

The current model pays doctors merely through capitation, which means physicians receive a fixed amount of compensation for every patient under their care. Its key advantages include the following:

• Consistent income
• More earning potential
• Flexible
• More opportunities
• Service is shared

Please consider that the FHO+ does not cancel out all the old model's features. It is technically an improvement on the old FHO model,[RA1] and new features were added to cover all the bases.

A key feature that is being removed from the new model is the Access bonus. This is an incentive for doctors to provide care to patients within their FHO. This incentive's features often put a great deal of administrative burden on the doctor.

FHO+ has the following new features:

• Easier for doctors to form FHOs

The old FHO model requires a minimum of at least 3 doctors to form an FHO, and will need to work together as a group and provide comprehensive care and on-call coverage to the group's patient roster. With FHO+ the minimum number of doctors is changed from 3 to 2. The FHO+ model also offers better co-location flexibility. This change makes it easier to maintain FHO groups.

• New billing system

As stated earlier, one of the key concerns of most FHO groups is that a great deal of their administrative tasks take up most of their time, and they are not paid for this as well. With the FHO+ physicians will be able to bill around $80 per hour. This new billing system will include telephone consultations, roster management, care planning, patient messaging, and administrative responsibilities.

• After-hours premium increased

The current FHO after-hour premium is currently 30%. With the FHO+ the after-hour premium is increased by 50%.

• Increased support for patient attachment

The FHO+ model will include increases in patient attachment bonuses. These increases include the following:

• Additional codes will be given for Health Care Connect upgrades (Q056) and Multiple Births (Q055)
• $100-$180 increase per rostered patient for established physicians
• An increase to Q053 from $350 to $500
• $150-$270 per rostered patients for new graduates
• A new Q054 Mother & Newborn Patent fee of $350

How does this affect Canadian Health Care in General?

Should the new compensation model be finalized and take effect next year, physicians will enjoy the following benefits.

• Increase of natural revenue

The most obvious effect of the new FHO model is that physicians can charge for their time even if it does not involve direct patient contact. The fact that they can charge for time used for administrative tasks means that they can earn revenue whether they are consulting a patient or even just billing tasks. From a physician's perspective, these steps are definitely on the right track. These changes show that their services are appreciated and that they have more opportunities to earn an income.

• Seamless practice management

The new FHO model has eliminated the access bonus feature of the old model. This means that some tasks such as monitoring patient-walk in clinic usage and restricting patient access to walk-in clinics are eliminated. This gives physicians more time to focus on patient care. Doctors will no longer need to maintain complex tracking systems to gauge their eligibility for the access bonus. With the new FHO model and the use of AI technology for medical administration, doctors will be able to manage their practices seamlessly.

• Reduction of burnout and improving patient care

Burnout is a key issue that many doctors face. Most doctors have only a finite amount of time in the day to focus on proper patient care. The stresses of the job are further exacerbated by administrative tasks that are not only time-consuming, but also unpaid with the old model. The new model will not only give doctors more chances of earning but also contribute to improved mental health and their performance as doctors.

This new compensation model is part of the Ford Government's promise to connect every Ontarian to a family doctor or primary care by 2029.

If the new compensation model proves successful, it may even galvanize other provinces to follow suit and change their own payment models and ultimately improve the administrative methods of clinics all over Canada.