Alternative Payments

Alternative Payments (AP) represent the remuneration provided to physicians who deliver services through methods other than fee-for-service. The AP models included within the scope of the Physician Master Agreement include Service Contracts, Sessional Contracts and Salary Agreements. Approximately 30% of physicians in British Columbia receive remuneration through AP models.

Alternative Payments Update – April, 2024

The 2022 PMA provided Service Contracted and Salaried Physicians with General Increases, Cost of Living Increases and, if applicable, Allocation Committee Increases. 

The 2022 PMA General Increases were applied to the Payment Ranges on an equal dollar per FTE basis, based on 3.0% for 2022/23, 2.0% for 2023/24, and 1.0% for 2024/25. The equal dollar increases for the Service Contract Payment Ranges and Salary Agreement Payment Ranges are as follows: 

The Cost of Living Increases are applied on an across the board basis to all of the Payment Ranges. The Cost of Living Increases are 1.25% and 1.0% in 2023/24 2024/25, respectively. 

The General Increases for 2022/23 and 2023/24 as well as the Cost of Living increase for 2023/24 were applied on an interim basis pending the conclusion of the Allocation Committee on further targeted increases. 

The Allocation Committee, a joint committee of Doctors of BC and Government representatives, reached an agreement on the allocation of $31.2 million over the three years of the PMA to address issues of disparity between the different practice categories and increased cost of business. The consensus decision of the Allocation Committee describing agreement and increases can be found here.

The adjusted Service Contract and Salary Agreement Payment Ranges, inclusive of General Increases, Cost of Living Increases and Allocation Committee increases are found below:

April 1, 2022/23 Final Service Contract Payment Ranges

April 1, 2022/23 Final Salary Agreement Payment Ranges

April 1, 2023/24 Final Service Contract Payment Ranges

April 1, 2023/24 Final Salary Agreement Payment Ranges

April 1, 2024/25 Final Service Contract Payment Ranges

April 1, 2024/25 Final Salary Agreement Payment Ranges

Alternative Payments Update – October, 2023

Service Contracted and Salaried physicians should now be receiving payments at the 2023/24 rates that incorporate the general increases and Cost of Living increase under the 2022 Physician Master Agreement (2022 PMA). The 2022 PMA general increases were applied to the Payment Ranges on an equal dollar per FTE basis, based on 3.0% for 2022/23, 2.0% for 2023/24, and 1.0% for 2024/25. The equal dollar increases for the Service Contract Payment Ranges were $11,022 and $7,348 in 2022/23 and 2023/24, respectively. The equal dollar increases for the Salary Agreement Payment Ranges were $9,841 and $6,561 in 2022/23 and 2023/24 respectively. In addition, the Payment Ranges were also increased by 1.25% effective April 1, 2023, based on the process outlined in Appendix J of the 2022 PMA.
 
The rates may be further adjusted by the 2022 Allocation Committee, a joint committee of the Government and Doctors of BC, which has until January 31, 2024, to reach an agreement on the allocation of $31.2 million to adjust the Payment Ranges to address issues of income disparity between the practice categories for physicians working under Service Contracts and Salary Agreements and to address the increase cost of doing business. In the event that the Allocation Committee is unable to reach an agreement by January 31, 2024, the available funding will be applied on an equal dollar per FTE basis to all Payment Ranges.

The Allocation Committee will be meeting beginning in November in an effort to reach an agreement and avoid a default allocation. In preparation for these discussions, the Doctors of BC’s Alternative Payment Physicians Issues Committee has worked with the Doctors of BC members of the Allocation Committee to identify Principles and Processes that will inform their positions during discussions with the Government. A document describing the Allocation Committee’s mandate, background information regarding alternative payments, the processes to be followed, and principles to inform decisions of, the Doctors of BC members of the Allocation Committee can be found below.

Allocation Committee Principles and Process 

2022/23 and 2023/24 Interim Service Contract and Salary Agreement Payment Ranges

April 1, 2022/23 Interim Service Contract Payment Ranges
April 1, 2022/23 Interim Salary Agreement Payment Ranges
April 1, 2023/24 Interim Service Contract Payment Ranges
April 1, 2023/24 Interim Salary Agreement Payment Ranges 

2023/24 Workload Funding Process Decisions

In total, 137 applications requesting funding for 367 new FTEs were submitted by Physicians. Due to the volume of Workload Funding applications received, the Government and Doctors of BC are completing the application review and allocation of 2023/24 workload funding in two phases. Phase 1 included a review of applications from the Emergency Department, Critical Care, and Hospitalist programs. Phase 2 included the remainder of the applications but may further allocations to some Emergency Department, Critical Care, and Hospitalist programs. The two-phase approach helped ensure the additional resources being made available through the 2022 Physician Master Agreement are responsive to evolving patient needs and program demands. 

In August, the Government released its Phase 1 funding decision of applications from Emergency Departments, Critical Care and Hospitalist Programs.

On November 7, the Government released its Phase 2 funding decisions for all applications.

2023/24 Workload Funding Process Decision Summary

2023/24 Workload Funding Allocation Summary

Historical Decisions and Process Documents (2010-2021):

2020 After Hours Adjudication Decision

2019-2022 Consensus Decision of the Allocation Committee
Report of the Chair of the Allocation Committee (Eric J. Harris Q.C.)

The Workload Funding Summary for 2021

2020/21 Workload Funding Allocation Summary 

2019 PMA Workload funding application 2021/22
2019 PMA Workload funding advice 2021/22

2022 PMA Workload funding application 2023/23

The Practice Category Settlement Agreement Consensus Decision

2017 Allocation Committee Consensus Decision (Residual) – February 25, 2019

2017 Allocation Committee Consensus Decision – April 30, 2018
(Range Adjustments for 2018/19)

2016 Allocation Committee Consensus Decision (Residual) – February 5, 2018
(Range Adjustments for 2017/18)

2016 Allocation Committee Consensus Decision - April 1, 2017
(Range Adjustments for 2017/18)

2015 Allocation Committee Consensus Decision - April 28, 2016
(Range Adjustments for 2016/17)

Alternative Payments Committee Consensus Decision – May 22, 2014
(Range adjustments for 2012/13 and 2013/14)

Alternative Payments Committee Consensus Decision – December 9, 2010
(Range adjustments for 2010/11 and 2011/12)

2010 - 2023 Service Contract and Salary Agreement Payment Ranges

Service Contract Ranges and Salary Agreement Ranges from 2010/11 to 2019 are found below. 

February 1, 2019 Service Contract Ranges
February 1, 2019 Salary Agreement Ranges

2018/19 Service Contract Ranges
2018/19 Salary Agreement Ranges

February 1, 2018 Service Contract Ranges
February 1, 2018 Salary Agreement Ranges

2017/18 Service Contract Ranges 
2017/18 Salary Agreement Ranges

2016/17 Service Contract Ranges 
2016/17 Salary Agreement Ranges 

2015/16 Service Contract Ranges 
2015/16 Salary Agreement Ranges

2014/15 Service Contract Ranges
2014/15 Salary Agreement Ranges

2013/14 Service Contract Ranges
2013/14 Salary Agreement Ranges

2012/13 Service Contract Ranges
2012/13 Salary Agreement Ranges

2011/12 Service Contract Ranges
2011/12 Salary Agreement Ranges

2010/11 Service Contract Ranges
2010/11 Salary Agreement Ranges

Sessional Rates

The following document summarizes updates to Sessional rates effective April 1, 2023.

2024 Sessional Rates
2023 Sessional Rates
2022 Sessional Rates
2021 Sessional Rates
2020 Sessional Rates

APSA

The 2022 Alternative Payments Subsidiary Agreement (APSA) is negotiated between Doctors of BC and Government. Part of the Physician Master Agreement (PMA), APSA details the employment conditions, contract standards and remuneration rates for all non-fee-for-service physician compensation. 

Service Contract

A service contract is between a physician as independent contractor and an Agency or the Government. A service contract will detail specific deliverables and working conditions, a level of service (usually expressed in hours per year) and a rate of remuneration based on FTE designation and range placement. 

2022 PMA – Service Template Contract (Individual)
2022 PMA – Service Template Contract (Group)

Sessional Contract

A session is defined as 3.5 hours of service. Sessions can consist of clinical or administrative work, or a combination of both. Rates of remuneration for sessions are negotiation between Doctors of BC and the Government, and are listed in APSA. 

2022 PMA – Sessional Contract Template (Individual)
2022 PMA – Sessional Contract Template (Group)

Salary

Salaried physicians are considered employees of the organization with which they enter into a Salary agreement. As such, these physicians receive regular scheduled remuneration along with any benefits or special employment arrangements provided by the employer.

2022 PMA – Standard Terms and Conditions Under Salary Agreements

Committees

Allocation Committee
Alternative Payments Physicians Issues Committee (APPIC)

Staff Contact

Tod MacPherson
Director of Negotiations
View Email Addresstmacpherson@doctorsofbc.ca
Telephone: 604 638 2885 or 1 800 665 2262
Fax: 604 638 2921