Alternative Funding for Doctors Supported by Audit

Alternative funding contracts help the province recruit and keep doctors and can be used to better enhance patient care, says a report by independent auditors.

In the spring of 2004, the Department of Health retained North South Group Inc. to conduct an audit of the province's largest and most complex Alternative Funding Plan, which is the current funding contract with the Dalhousie/Capital Health Department of Medicine group of doctors.

The final report was recently presented to Health Minister Angus MacIsaac.

"This funding plan was an ideal contract to review because it incorporates patient care, academic teaching, and research -- all aspects of the work many Nova Scotian doctors do," said Mr. MacIsaac. "This audit report is the first of its kind in Canada and its recommendations will be extremely useful to improve our contracts with doctors and ensure accountability within the health-care system."

The audit focused on financial aspects, value for money, and contract management. The audit report provided 42 recommendations to improve how alternative funding plans are negotiated, written, and monitored.

Nova Scotia is a national leader in offering alternative funding plans for physicians. In 1997-98, about nine per cent of doctors were paid solely through alternative funding. Today, about 30 per cent of Nova Scotia's doctors are paid this way. Nova Scotia has more than 200 separate alternative funding contracts either with individual doctors or groups of doctors. These are primarily rural family doctors and some specialists in both rural and urban centres. In 2003-04, the Department of Health paid $125 million for alternative funding payments to physicians.

"Being on the leading edge and encouraging new approaches to providing medical services comes with a learning curve -- we expected many of these recommendations," said Mr. MacIsaac. "The next step is for the department to review each recommendation and develop action plans that would ensure value for taxpayers, for patients, and for the health system."

The contract for North South Group Inc. to conduct the audit was worth $200,000. A copy of the full audit report is available on the Department of Health website at www.gov.ns.ca/health/reports.htm .