1. College of Physicians and Surgeons of Ontario QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST IHF/OHP Fee Model IDCA Conference September 20, 2013 Wade Hillier Acting Director, QMD

2. College of Physicians and Surgeons of Ontario Program Costs Allocated according to staff complement relative to overall College staffing levels Spread across facilities and premises Assessment Costs Assessments based on cost recovery Full cost of the assessment is paid by the location being assessed Invoiced ‘at cost’ for each assessment by assessors and directly attributed to an assessment Vary on assessment location, specialization, and other factors that affect the time required for the assessment Vary with respect to the number of assessments provided across each program area year over year  IHF – 250 per year  OHPIP – 250 over 5 years Current approach

3. College of Physicians and Surgeons of Ontario Process for building a pricing strategy Develop roadmap Select pricing options Define evaluation approach Create a list of pricing options Identify guiding principles for pricing Peer review findings Assess stakeholder needs 2 2 3 3 4 4 5 5 6 6 7 7 8 8 Current approach to costing and pricing 1 1

4. College of Physicians and Surgeons of Ontario Who did we talk to? Ontario Labs – QMP LS CPSA Diagnostics CPSBC Medical Council of Canada Accreditation Canada

5. College of Physicians and Surgeons of Ontario Guiding Principles of the IHF/OHP Fee Model 1 Full cost recovery2 Economic independence of programs  Fees and prices will be set to sufficiently cover all costs to ensure economic sustainability  Short term surpluses or deficits will be balanced accordingly over time to provide long term cost recovery  Revenues from program areas will not be used to fund or subsidize costs of other programs  Indirect costs will be allocated to programs using a reasonable cost driver 3 Universality4 Long run cost averaging  The College will provide fee standardization to average costs across assessments  Total fees charged will not vary based on factors that are outside the control of the assessed entity  The College will average costs over an appropriate time frame to reduce impact of extraordinary expenses for both its own budgeting purposes and for the assessed entity 5 Efficiency6 Transparency  The College will deliver the assessment programs at lowest cost possible while still providing value-add services to clients  The College will seek a pricing strategy that aims for simplicity and clarity  The College will provide a degree of visibility into the formulas, processes and rates used to determine prices The guiding principles informed the pricing considerations used to assess the pricing options and develop the overall pricing strategy

6. Fee Model Indirect cost allocation Indirect cost allocation Invoicing & collections Extra charges Staff based allocation Assessment charges Facility/premises fee by modality / level Facility/premises fee by modality / level Additional charges Reassessment charges Pre-payment Fee basis Long run cost averaging Annual fee only Average Fee structure Pricing stability The cost of the assessments will be averaged so an assessment has one fee The college will charge a fee annually rather than bill separately for assessments College to continue to allocate indirect College costs based on relative staffing levels The assessment portion of one annual fee will vary by modality or level in relation to average costs for that modality/level Fees to be spread across 5 year cycles to avoid “random” variations in fees year to year Clients to be charged for additional costs as appropriate Pre-payment to be required prior to conducting assessments (as part of the annual fee)

7. College of Physicians and Surgeons of Ontario Levels/Modalities OHP Level 1 : $3,895 Level 2 : $4,175 Level 3 : $4,490 IHF Diagnostic : $1,680 Sleep Medicine : $1,990 Ambulatory Services (plastic surgery, abortion clinics) : $1,710 Ophthalmic Ultrasound/ Simple PFT : $ 605

8. College of Physicians and Surgeons of Ontario Payment Information Facilities will be invoiced on November 1, 2013 with payment due within 30 days of receiving a College invoice According to the College’s Fees and Remuneration By-Law outstanding fees will be subject to an interest charge 1.5% per month If the licence holder does not pay the outstanding fees in full, within 30 days of receipt, further action will be taken.

9. College of Physicians and Surgeons of Ontario Transferred/Sold Licenses If you have transferred/sold the IHF license to an new licensee during the annual billing period, this is considered part of the business transaction between you and the new licensee If the former licensee does not pay for the annual fee at the time it is invoiced, the fee and interest incurred will be the responsibility of the new owner/operator

10. College of Physicians and Surgeons of Ontario Questions