Highlights
Background
Revised CANDI Scores
Toward A New Relativity Approach
Dear Colleagues:
I have news to share on relativity. Highlights are provided up top with the full details below.
Highlights
- CANDI scores for Year Four will be updated based on the most recent billing data available.
- CANDI scores will also be updated for after-hours work and daytime hours of work based on the final report of the third-party consultants, online here.
- The Board has approved funding up to $10,000 per Section to reimburse external work done to support the review of after-hours work and hours of work.
- The Relativity Advisory Committee will not work on any further changes to the OMA CANDI scores. Nearly every Section has a problem with CANDI. So the Relativity Advisory Committee will instead work on a more acceptable relativity approach for the next round of negotiations.
Background
The Phase I Arbitration award is a four-year agreement. It includes compensation increases in each of four years — 0.75%, 1.25%, 1% and 1% — where allocation would be decided in Phase II. Allocation is the process by which new monies are divided up among members.
This allocation would use a hybrid relativity model for the 2017/18 and 2018/19 fiscal years as per the interim relativity agreement. The hybrid relativity model assigns a ranking to each specialty based on the average of their CANDI (the OMA relativity model) and RAANI (the government’s relativity model) scores. Given how much time has passed, this method was extended to 2019/20 as well.
For 2020/21, Year 4 of the agreement, the OMA has an opportunity to update the CANDI score for each OHIP specialty.
Revised CANDI Scores
Many Sections have expressed concerns with the after-hours modifier in the CANDI formula. To ensure a level playing field, Council approved an independent, binding third-party review of the after-hours and daytime work hours modifier. This process is now complete, and all CANDI scores will be updated as a result.
In completing its work, the consulting group reviewed evidence from OHIP claims data, available surveys and evidence submitted by OMA Sections. They also met with OMA Sections in person.
- The final report, Section submissions, and updated CANDI scores and analysis are now available on the OMA Relativity Reference page here.
Council requested that the OMA support Sections that participated in this process. To this end, the Board has approved funding to reimburse these Sections, up to a maximum of $10,000, for external costs that do not include Section members’ time and the analytical support provided by the OMA Economics, Policy and Research Department. For details, please e-mail accounts.payable@oma.org.
Council also requested that the OMA update CANDI scores each year as new billing data becomes available. As such, CANDI scores for the fourth year will be updated based on the additional year of data that has become available since the interim relativity agreement was discussed (fiscal 2017/18).
Toward A New Relativity Approach
Recently, Sections have written to the Relativity Advisory Committee (RAC) requesting further changes to CANDI. To address these concerns fairly would mean:
- An open call to all Sections for revisions;
- A mechanism to support all groups in providing their revisions;
- An interval to allow groups to prepare;
- Sufficient time for the RAC to review requests;
- An approved dispute resolution and appeal mechanism; and,
- Approval by Council of both the process and final approval of CANDI scores.
At the same time, implementation of Year 4 increases is to be done by April 2020. Given this timeline, it is not feasible to complete further changes to CANDI. Therefore, RAC will not work on any further changes to CANDI scores.
CANDI is but one of many possible relativity approaches. RAC will focus their full efforts reviewing all available relativity models with the expectation that they will propose a more acceptable relativity approach for the next Physician Services Agreement.
RAC will hold a pre-Council education session about this work on Friday, May 3, 2019 at 10:00 a.m., and in its progress update to Council on Saturday, May 4. Background material is already posted on the OMA Relativity Reference page here. I encourage you to review this material as the RAC will be consulting extensively with members.
Thank you for reading this far. As always, if you have any questions about relativity, the various models, or the RAC work going forward, please contact relativity@oma.org.
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Warmest regards,
Nadia Alam
OMA President
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