What are 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 Payment updates
September 2024
In August, the Government announced its Workload Funding Process decisions for 2024/25 for Service Contracted and Salaried Physicians experiencing significant and sustained increases in workload.
In total, 96 applications requesting funding for 269.6 FTEs were submitted by Physicians.
Pursuant to the processes outlined in the 2022 Alternative Payments Subsidiary Agreement, the Government has allocated $42.4 million dollars to support 103.2 new FTEs. 80 of the 96 applicants received additional funding through the Workload Funding process this year.
Future Workload Funding processes will be determined as part of the 2025 PMA Negotiations.
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:
| Year | Service Contract Payment Ranges | Salary Agreement Payment Ranges |
|---|---|---|
| 2022/23 | $11,022 | $9,841 |
| 2023/24 | $7,348 | $6,561 |
| 2024/25 | $3,568 | $3,186 |
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 and 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 the increased cost of business. Read the consensus decision of the Allocation Committee describing the agreement and increases for details.
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
Workload funding process decisions
2024/25 Workload funding process decision summary
Access the 2024/25 Workload funding summary.
2023/24 and 2024/25 Workload funding process decisions
The 2022 PMA provided a total of $128.75 Million to fund additional full-time equivalents of Physician Services (the FTEs) to address workload pressures of Physicians on Service Contracts or Salary Agreements. This funding was released over two years. The outcome of the funding process resulted in a decision in November 2023 to allocate the first $86.35 Million for the 2023/24 fiscal year, and in August 2024 the remaining $42.4 Million was allocated for the 2024/25 fiscal year, thereby fully allocating the $128.75 Million provided for in the 2022 PMA.
Future Workload Funding Processes will be determined under the 2025 PMA.
Historical decisions and process documents (2017-2023)
Historical decisions and process documents (2017-2023)
2023/24 Workload Funding Allocation Summary
2022 PMA Workload funding application 2023/23
2021 The Practice Category Settlement Agreement Consensus Decision
2021 Report of the Chair of the Allocation Committee (Eric J. Harris Q.C.)
2021/22 Workload Funding Allocation Summary
2020/21 Workload Funding Allocation Summary
2020 After Hours Adjudication Decision
2019-2022 Consensus Decision of the Allocation Committee
2019 PMA Workload funding application 2021/22
2019 PMA Workload funding advice 2021/22
2017 Allocation Committee Consensus Decision (Residual)—February 25, 2019
2017 Allocation Committee Consensus Decision—April 30, 2018
(Range Adjustments for 2018/19)
Service Contract and Salary Agreement Payment Ranges (2017-2022)
Service Contract Ranges and Salary Agreement Ranges from 2017/18 to 2022 are found below.
2021/22 Service Contract Range
2021/22 Salary Agreement Ranges
2020/21 Service Contract Range
2020/21 Salary Agreement Ranges
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
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 an 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 negotiated 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 regularly scheduled remuneration along with any benefits or special employment arrangements provided by the employer.
2022 PMA—Standard Terms and Conditions Under Salary Agreements