The Nova Scotia program is patient-centred rather than disease-centred, and recognizes that many patients have more than one chronic disease, which may have common risk factors. Family physicians converting to the new LFM payment model will receive CDM within their base salary. LFM physicians will receive 30% of the value as part of their fee-for-service billings.
CDM incentive payments
Eligible GPs are paid as follows:
- $100 base incentive payment once per fiscal year for managing an annual cycle of care and addressing the required indicators/risk factors for each patient with one qualifying chronic disease
- $75 additional payment per fiscal year if the same patient is managed for a second qualifying chronic disease (total payment of $175)
- $50 additional payment per fiscal year if the patient is managed for three qualifying chronic diseases (total payment of $225)
Note: Completion of the COPD Action Plan, if applicable, is included in these payments.
The CDM incentive is claimed through a fee code. APP contract physicians are also eligible for the incentive and are paid by cheque based on their aggregate shadow billings.
Qualifying chronic diseases
The qualifying chronic diseases are:
- Type 1 and Type 2 diabetes
- Ischaemic heart disease (IHD)
- Chronic obstructive pulmonary disease (COPD)
Required indicators/risk factors
In order to claim a CDM incentive payment there are indicators/risk factors that are required to be addressed as part of the annual cycle of care.
Chronic Disease Management flow sheet
A Family Physician Chronic Disease Management flow sheet has been developed to help you document the care required to bill this fee. Use of the flow sheet is optional.
Full details on how to bill this code can be found on page 2 of the March 28, 2014, MSI Physicians’ Bulletin.