Long-term Care

Updated August 26, 2024

Important update: In July 2024, in alignment with the incorporation of long-term care services in the LFP Payment Model (login required), the current LTCI (Long-Term Care Initiative) funding ($400 per year per LTCI bed) will be reallocated within the initiative to the following payments:

  • FPSC Long-term Care On-Call/Availability Funding—administered by divisions
  • FPSC Quality Improvement (QI)/Administration Funding for LTCI—administered by divisions
  • FPSC LTCI Payment for FPs (family physicians) not eligible for the LFP Payment Model—direct payments to family physicians

The final payment based on the current LTCI funding formula will be released to participating divisions in June 2024. Application and administration information related to the new LTCI payments will be shared in the coming months.

Since 2015, the Family Practice Services Committee (FPSC) has provided approximately $12-million annually through the LTCI to support family physicians who deliver long-term care.

Divisions of family practice receive funding to organize and coordinate family physician MRP (Most Responsible Physician) services to patients in long-term care facilities through the LTCI. 

The LTCI is designed to support physicians to develop local, scalable, and sustainable solutions that target meeting the following five best practice expectations and three system-level outcomes:

Best Practice Expectations

  • 24/7 availability and on-site attendance when required
  • Proactive visits to residents
  • Meaningful medication reviews
  • Completed documentation
  • Attendance at case conferences

System-Level Outcomes

  • Reduced unnecessary or inappropriate hospital transfers
  • Improved patient/provider experience
  • Reduced cost/patient as a result of a higher quality of care

For long-term care specific billing support for fee-for-service physicians, please visit BC Family Doctors (login required) for up-to-date billing information/fee codes.

What’s new?

In July 2024, FPSC introduced the following funding programs to support family physicians long-term care.

Long-Term Care

• FPSC On-Call/Availability Funding for Long-Term Care – Each division will receive an annual amount of $130,000 + $80 per LTCI (Long-Term Care Initiative) bed. The divisions of family practice will administer this funding.

• FPSC LTCI Most Responsible Provider Payment – Family physicians (FPs) who provide ongoing longitudinal care to patients in long-term care facilities and are participating in the FPSC Long-Term Care Initiative (LTCI) but are not eligible for the Longitudinal Family Physician (LFP) payment model can now apply to receive a LTCI MRP (Most Responsible Provider) payment. Click here for more details.

What’s changing?

To support the new funding programs, FPSC is reallocating funding from the following FPSC programs.

Long-Term Care

• Long-Term Care Initiative (LTCI) – $400 per year per LTCI bed administered by divisions of family practice. Divisions received the final payment in June 2024.

What remains the same?

Long-Term Care

• FPSC LTCI QI (Quality Improvement)/Administration Funding – Local long-term care QI activities currently funded by LTCI will continue to receive financial support.

Role of the divisions of family practice

The divisions of family practice have a key role in communicating local challenges and gaps in care, collaborating on solutions, supporting physician practices, amplifying physician voice, and influencing primary care delivery in their own communities. The divisions also have an important role in supporting the changes associated with new physician payment arrangements and options. Divisions will be responsible for administering the new FPSC On-Call/Availability Payments and supporting physicians in organizing call groups. FPSC will continue to fund the divisions of family practice to support their activities in recruitment and retention, supporting physician practices and physician networks, and system and quality improvement work.

 

FPSC funding supports for Long-Term Care

What are the important dates to know for FPSC funding changes for long-term care?

The table below outlines the important dates for current and future FPSC funding supports for long-term care.

When can family physicians start billing the LFP Payment Model time codes and interaction codes for long-term care services?

New LFP Payment Model time codes and interaction codes for long-term care services were made available to eligible family physicians in June 2024. 

What will happen to the FPSC Long-term Care Initiative (LTCI)?

In July 2024, the current LTCI funding ($400 per bed) was reallocated to fund the following :

  • FPSC On-Call/Availability Funding for LTC – administered by the divisions of family practice
  • FPSC On-Call/Availability Administration Funding for LTC – administered by the divisions of family practice
  • FPSC LTCI QI/Admin Funding for LTCI – administered by the divisions of family practice
  • FPSC LTCI Payment for FPs not eligible for LFP Payment Model – direct payments to family physicians

The final payment based on current LTCI funding formula was released to participating divisions of family practice in June 2024.

New FPSC On-Call/Availability Funding for Long-term Care 

What is the FPSC On-Call/Availability Funding for Long-term Care and when will it be available?

In July 2024, a new FPSC On-Call/Availability Funding for Long-term Care program was made available to support family physicians to work together to provide after hours on-call availability to LTC patients. This funding program will provide an amount of $130,000 per division + $80 per LTCI bed. Divisions can apply for additional funding to support the administration cost of operating call groups.

The funding is administered by the division of family practice, and the maximum payable per participating physician is $21 per on-call hour. Additionally, while a physician is on-call, all patient services they provide will be compensated by the LFP Payment Model or any other payment model (e.g. fee-for-service or AP contract) by which the physician is compensated. 

Will family physicians be paid less for on-call availability with the new FPSC On-Call/Availability Funding for Long-term Care?

Currently, payment rates for on-call availability vary significantly across the province. The new FPSC On-Call/Availability Funding for Long-term Care is designed to provide equitable compensation for on-call availability across the province. Family physicians providing on-call availability will be compensated by the new FPSC On-Call/Availability Funding for Long-term Care program (max $21 per hour) and by their applicable payment model for patient services provided when they are on-call. 

The LFP Payment Model for Long-term Care provides significant payment premiums for direct patient care services provided after hours. 

Can family physicians receive more than one on-call/availability payment if they are providing on-call coverage for inpatient and long-term care at the same time?

No. If a family physician is providing on-call coverage for inpatient and long-term care at the same time, they can only receive one on-call/availability payment for this time. While the family physician is on-call, the patient services they provide in hospital or long-term care are compensated by their applicable payment models.

Can family physicians receive more than one on-call/availability payment if they are providing on-call coverage for multiple communities at the same time?

No. If a family physician is providing on-call coverage for more than one community at the same time, they can only receive one on-call/availability payment for this time. While the family physician is on-call, the patient services they provide are compensated by their applicable payment models.

Can family physicians receive on-call/availability payments from more than one division?

If a family physician is providing on-call coverage for more than one community at the same time, they can only receive one on-call/availability payment for this time. If a family physician provides on-call coverage for one community for one time and for another community at a different time, they may receive on-call/availability payments from different divisions.

What is the FPSC LTCI (Long-term Care Initiative) QI (Quality Improvement)/ Administration Funding? 

The FPSC LTCI QI/Administration Funding provides continued financial support to divisions to engage in local LTCI QI activities to support the iterative design and implementation of local solutions that deliver dedicated MRP (Most Responsible Physician) services for patients in long-term care facilities. Funds are based on the QI and administration budget outlined in each division's fiscal year 2023/24 MOU (memorandum of understanding). 

Funds may be used to support quality improvement and educational activities such as projects (e.g., streamlining admissions or SBAR usage), developing educational materials, mentoring, CME (continuing medical education) and LTCI Steering Committee; physician sessional time for non-clinical LTCI leadership or quality improvement activities; division administrative or LTCI project management staff support and costs supporting QI activities such as facility rental and catering costs.

More details will be communicated to divisions in the coming months.

New FPSC LTCI MRP Payment for family physicians (under Fee-for-Service) not eligible for LFP Payment Model

What is the FPSC LTCI MRP Payment for family physicians (under Fee-for-Service) not eligible for the LFP Payment Model (login required)?

This payment is intended to help family physicians (under Fee-for-Service), who are not eligible for the LFP Payment Model (login required), to maintain their long-term care services. Starting in July 2024, Fee-for-Service family physicians participating in the LTCI (Long-Term Care Initiative) and who are not eligible for the LFP Payment Model (login required) could claim an amount of $290 per year per long-term care bed, up to a maximum annual amount, for which they are the MRP (Most Responsible Physician). 

To be eligible for this payment, family physicians must meet all of the following requirements:

  • Be actively participating in the LTCI and providing long-term care services as of [first day of quarter] according to the following best practice expectations:
    • 24/7 availability (as a collective group) and on-site attendance when required.
    • Proactive visits to residents.
    • Meaningful medication reviews.
    • Completed documentation.
    • Attendance at case conferences.
  • Commit to maintaining long-term care services according to LTCI best practice expectations until [last day of quarter].
  • Do not meet the eligibility requirements of the LFP Payment Model. Family physicians who meet the eligibility requirements of the LFP Payment Model but choose not to participate in the LFP Payment Model are not eligible for this payment.
  • Bill under Fee-for-Service for LTC services. Family physicians who are compensated by AP contract (e.g., sessional payment or service contract) are not eligible for this payment.

More details, including how physicians can claim the payment, will be communicated in the coming months.

 

More information:

For questions or details on available resources, contact: fpscltci@doctorsofbc.ca.