PSA Implementation Update: Payment Timelines, Relativity Impact & What's Next

Dear SGFP Members,

I want to provide you with our insights and important information regarding Physician Service Agreement (PSA) implementation from this year’s arbitration award, including:

• the implementation of the 9.95% increase for Year 1 (2024-28 PSA), ‍
• the 2.8% increase implementation from Year 3 (previous PSA), and
• a payment calculator to help you estimate lump sum payments owed to you.  

This letter includes our insights on the recent implementation announcement and its impact on family medicine, as well as an overview of the payment timelines and what you can expect next.

• The SGFP Executive attended the OMA General Assembly this past weekend and took the opportunity to talk with OMA directly to have our questions answered.
• We have been in frequent contact with the OMA regarding this implementation and have been advocating often with our expectations on your behalf.    
• Our Tariff Lead and team have had regular contact with OMA staff as well as engaging other Sections and MIGs.

What This Implementation Means for Family Medicine

We have concerns about the approach to this implementation. We know that relativity adjustments have been crucial to address the undervaluation of family medicine relative to other specialties. Thus, SGFP had advocated for 100% of the arbitration award to be allocated through relativity. Unfortunately, this was not achieved, resulting in a 75/25% split.  

Though a timeline has been established, we are disappointed that the permanent implementation has been delayed until April 2026. However, we understand that this delay offers the Physician Payment Committee time to modernize the schedule and address the gender pay gap, complexity and other pressing issues.

The OMA has clarified that the relativity categories for family medicine (GP1, GP2, GP3) will no longer apply in implementing the Year 1 and Year 3 increases. Instead, all family physicians will be treated uniformly as it pertains to distribution of funds based on relativity.  

The OMA has shared information about the timing and structure of these payments, which I know many of you have been eager to understand. We encourage members to take a look at the OMA calculator on the members' page; this tool will help you estimate the amounts of the two lump-sum payments expected in 2025.  

Key Payment Timeline - Here's what you can expect:

• November 2024: 2.8% lump-sum payment for services provided between April 1, 2023, and March 31, 2024 ‍
• January-March 2025: Combined increase of approximately 13% applied to services rendered during this period ‍
• May 2025: Retroactive payment of 9.95% for services from April-December 2024 ‍
• April 2025-March 2026: Implementation of relativity-adjusted increases (75% relativity/25% across-the-board split) ‍
• October 2025: Final reconciliation payment for the 2024-25 period ‍
• April 2026: Permanent implementation of relativity-based fee increases through the Schedule of Benefits

We thank the Negotiations Task Force (NTF) for advocating strongly for earlier implementation of these increases. We understand that the Ministry’s current IT systems and capacity limitations necessitated the extended timeline, which is frustrating after years of facing rising practice costs.  We have encouraged NTF to ask for interest owed on these overdue payments.

Looking Ahead

In the coming weeks, we expect to receive more details about the specialty-specific increases based on CANDI/RANDI scores. For many years now, the SGFP has advocated to have the relativity model revised. As this information becomes available, we will be better positioned to understand and communicate what these changes mean for you.

These changes will be permanently implemented as of April 2026 under the PPC framework, and this presents an opportunity for Sections to submit proposals to the PPC. The SGFP will actively engage with members to put proposals forward that will contribute to stabilizing family medicine, fairly compensating the profession, and ensuring the sustainability of our practices.  

Next Steps

We will share more detailed information about relativity and other implementation considerations with you as we receive them. We recognize that members will question how these changes affect different practice models and payment structures. We are working to develop clear and concise ways to share this information with you and ensure your voices are heard in this process.

Ending on an Alarming Note

Many of you may have heard that our colleague Dr. Elaine Ma is facing an OHIP Health Services Appeal and Review Board due to the delivery of vaccine services provided during the height of the COVID-19 pandemic (read article). We have talked with OMA to ensure that they are advocating on her behalf.  We will continue to be in close contact with OMA on this situation and ensure that any support needed from SGFP is provided.

Thank you for your ongoing dedication to providing excellent patient care during these challenging times. We will continue to advocate for solutions that strengthen family medicine in Ontario.

Warm regards,

Dr. David Barber
Chair, Section on General and Family Practice