How does compensation work?

Our goal is to provide a superior clinic and physician working environment, at competitive rates. As our market research indicates that a 70/30 split for most billings is standard, our fee structure is structured to achieve this result.

We do, however, plan to make an exception for new grads who are joining us via the three-year NGEP program. In particular, we are willing to adjust our fee structure for the first few years in order to share in the financial impact of this program.

Notably, this fee structure is inclusive of the HST that must be charged on our management fees.


Is Magenta Health a FHO?

Yes - we're a Family Health Organization (FHO) and originally the intent was that all physicians who work with us would join our FHO as well. We enjoy the FHO's ability to roster patients and to provide care in a more continuous and accessible manner.

Unfortunately, due to current MOH policies, entry into FHOs in Toronto is restricted and only new grads are able to join the Magenta Health FHO via the NGEP program. The arbitration decision between the MoH and the OMA has not changed this situation. The entry restrictions remain and the situation is unlikley to change before the next set of OMA - MoH contract negotations (scheduled for 2021/2022).


Is Magenta Health a FHG?

Yes - we're also a Family Health Group (FHG). We started the FHG to accomodate additional family physicians who are not able to join the Magenta Health FHO, or do not wish to participate in the NGEP program. We have also worked out how FHG and FHO physicians can work together in a single clinic.


I'm a new grad: NGEP vs. FHG?

After three years, nine doctors in the NGEP program, and successful graduation of doctors out of the NGEP program, we think the NGEP program is better for new graduates in most cases. Some advantages of the NGEP program:

  1. Work where you want to work with no restrictions on practice location
  2. A chance to build and train your own practice
  3. A clear confirmed pathway to a full signatory FHO position
  4. No restrictions on where your patients are located (versus other income stabilized programs)

There are some drawbacks to the NGEP program:

  1. There is a negative financial impact if compared to working in a rural high needs area
  2. Participating physicians have a restricted ability to provide care outside the FHO

As detailed below, we’ve worked hard to address and mitigate both of the above drawbacks.

Financial Impact

The NGEP program currently offers annual gross income of $162K, $178K, and $207K to participating physicians. Our calculations, as shown below, suggest that the standard NGEP program is a 10.0% reduction in base payments, over five years, as compared to the income stabilization program offerred in a rural high needs area.

For IS, years 2 - 5 are estimated amounts assuming 825 patients corresponds to $201,000 gross income with all bonuses fully met, minus the current 3.15% Ministry of Health OHIP clawback; For NGEP, years 4 and 5 are estimated amounts using the same assumptions, minus the current 3.15% Ministry of Health OHIP clawback.

For IS, years 2 - 5 are estimated amounts assuming 825 patients corresponds to $201,000 gross income with all bonuses fully met, minus the current 3.15% Ministry of Health OHIP clawback; For NGEP, years 4 and 5 are estimated amounts using the same assumptions, minus the current 3.15% Ministry of Health OHIP clawback.

In order to offset this financial impact, Magenta Health is able to adjust our fee structure, up to as follows, to reduce the impact from 10.0% to 5.0%. Put another way, over 5 years, the impact of the NGEP program could be reduced to less than $9,000 annually over 5 years.

For IS, years 2 - 5 are estimated amounts assuming 825 patients corresponds to $201,000 gross income with all bonuses fully met, minus the current 3.15% Ministry of Health OHIP clawback; For NGEP, years 4 and 5 are estimated amounts using the same assumptions, minus the current 3.15% Ministry of Health OHIP clawback.

For IS, years 2 - 5 are estimated amounts assuming 825 patients corresponds to $201,000 gross income with all bonuses fully met, minus the current 3.15% Ministry of Health OHIP clawback; For NGEP, years 4 and 5 are estimated amounts using the same assumptions, minus the current 3.15% Ministry of Health OHIP clawback.

Metrics

According to the Ministry of Health documentation, participating physicians must meet or exceed performance improvement targets in order to graduate from the NGEP program.

Happily, we recently graduated our first physician out of the NGEP program. Our technology and administrative processes greatly aided in meeting targets. For example, accessibility is a measured indicator and we're one of very few primary care clinics in Canada that offers online scheduling to the extent we do; by default, 100% of patients have access to same day / next day appointments.

Put simply, we think Magenta Health NGEP physicians are well-placed to meet Ministry of Health performance targets.

Providing care outside the FHO

Recent changes to the program have delivered improved flexibility for physicians to simultaneously provide care within and outside the FHO. In particular, full-time physicians (i.e. 1.0 FTE) can provide up to $35,000 in outside services annually for the first three years (albeit with some caveats).

What is more helpful is that this amount is pro-rated upwards if a physician is not part of the program full-time, meaning, for example, a 0.7 FTE NGEP physician has a cap of $83,600 annually instead of $35,000.

Some of our NGEP physicians currently work outside of the FHO in low risk obstetrics, women’s health clinics, and breast clinics.


Is there a walk-in component?

No, we do not anticipate operating any walk-ins. Instead, Magenta Health is currently designed to operate by appointment only, including urgent and last-minute appointments.

All of our clinics currently have a patient waitlist. In the past, we also invested in online, print, and direct advertising to ensure physicians were appropriately busy, in lieu of operating a walk-in.


Questions or Interested in Visiting?

Contact Dr. Marco Lo with any questions or if you'd like to schedule a visit.