By: Dr. William Hogg
A major change to the way health services are organized is underway in Ontario. Eventually, the entire province will be divided into Ontario Health Teams each serving around 300,000 people. A regional geographic approach (LIHNs) is being replaced with a district level approach based on an analysis of existing patient flow patterns from family physicians to hospitals. Out of many first stage expressions of interest, three Ottawa area groups have been invited to submit full applications. If they are successful they will begin functioning as “candidate” Ontario Health Teams by December 2019. They will start small focusing on a target group of patients and expand over several years to cover all health care needs for an entire designated population.
The focus of Ontario Health Teams is on integration and coordination of care across health care sectors. The government clearly recognizes the importance of primary care and requires each OHT to have strong primary care leadership and engagement.
They will operate with an integrated funded envelope and take a digital-first approach, which includes virtual visits. At maturity, the OHTs will be the fund holder for all patient care costs from hospitalizations, to drugs, to home care, to primary care visits. There will be a risk-adjusted population-based blended funding arrangement. There will be a shared savings incentive structure to reward Ontario Health Teams that realize efficiencies and exceed performance targets. The focus on keeping patients out of the hospital and away from the Emergency room explains the emphasis the government is giving to primary care.
Pay attention as there is great potential to improve the quality of care you provide your patients and your paymaster will eventually change to an Ontario Health Team.