1. Overview of The Submission to the Ministry of Health and Long-Term Care In Response to Technical Fee Reimbursement in Ontario And a Request to Form a Technical Reimbursement Governance Committee Submitted Jointly by: IDCA & OHFA On behalf of the IHF Sector in Ontario October 30, 2011

2. Why a Governance Structure? There is currently no advisory group providing the Ministry with recommendations on the current or future needs of diagnostic technical services’ delivery in Ontario. This need can be best addressed by a committee of experts involved in the delivery of services. A governance structure with equal representation from all key stakeholders (OMA, OHA and IHF sectors) allows those directly impacted to provide input on issues relating to reimbursement, quality assurance and facility operations. The committee’s recommendations would be based on the understanding that Ontarians expect and deserve high quality accessible, evidence-based care.

3. IHF Sector Recommendations The operating complexities relating to the delivery of hospital and community-based services are so inherently different that a single committee apparatus would not be appropriate. A steering committee with a paralleled sub-governance structure, allowing for focused committees, each with distinct responsibility over institutional or community-based service, would provide expert-based recommendations to the paramount steering committee. Task groups, comprised of committee members and outside experts, would be established on an ad-hoc basis to address specific operating and service delivery issues.

4. IHF Sector Recommendations (Cont’d) Our underlying assumption is that Ontarians require access to both hospital and community-based services and that the viability of both sectors is important to ensure that the principles of quality, accessibility and sustainability are maintained. A clear mandate, including goals, objectives and desired outcomes of this committee structure must be documented to ensure that appropriate actions are pursued and for transparency of action. To ensure accountability of action, an agreed upon evaluation method of this structure and committee members will be implemented.

5. Diagnostic Services Governance Structure Organizational Design Community Diagnostics Governance Sub-Committee (managing community-based portion of technical fee funds) Hospital Diagnostics Governance Sub-Committee (managing institution-based portion of technical fee funds) Emerging Technology Equipment Working Group Quality/Patient Experience Technical Compensation Others as required Diagnostic Services Steering Committee [IHF/OMA/OHA Membership] Providing Ministry with recommendations from both IHF and hospital diagnostic technical services sectors Ministry of Health and Long Term Care

6. Diagnostic Service Governance Structure Membership Composition Technical Services Fee Steering Committee 4 members each from IHF, OMA & OHA 1 MoH representative/advisor (non-voting) 1 MoH assigned secretary (non-voting) Community Diagnostics Governance Sub-Committee 4 IHF Steering Committee members 2 OMA Steering Committee members 1 OHA Steering Committee member 1 MoH representative/advisor (non-voting) I MoH assigned secretary (non-voting) Hospital Diagnostics Governance Sub-Committee 4 OHA Steering Committee members 2 OMA Steering Committee members 1 IHF Steering Committee member 1 MoH representative/advisor (non-voting) 1 MoH assigned secretary (non-voting)