Sessional Model

Sessional Model

Funding

• The model was designed to fund physicians for part-time practices. 
• Funding is based on the number of hours required to deliver ARP services, multiplied by the hourly funding rate.
• Allows for part-time physician participation approximately 16 hours per week and to a maximum of 832 hours annually.
• The funding rate is currently $228.45 per hour for all specialties. 
• As with FFS, overhead is included in the cARP rates; therefore, any current overhead expenses would be paid from the cARP revenue, unless other arrangements are made (e.g., partnership with AHS or a third party). 
• Smaller, specialized programs generally use the sessional model, but it can also be used for a smaller segment of overall services.
• As with the annualized model, physicians can bill FFS for-service for non-ARP services outside of the hours they are providing ARP funded services.

Payments

• Funding is transferred to the program or directly to the physician based on time-modifiers utilized with the shadow billing.
• If a program provides more service hours than are funded, then they are not entitled to additional payments.

Program Services

• Each program needs to define the basket of service that will be in-scope for the practice. For example, a practice may decide low-risk maternity and delivery are out-of-scope.
• Program services include both direct and indirect patient care. 
• Program services do not include physician on-call availability. Only the actual time physicians spend delivering program services while on-call is funded. 
• Program services include any out-of-province (medical reciprocal) patients.

Locum Services

• Locum services are included in the FTEs for the program and are paid out of the clinical ARP funding. The actual amount required to attract locums for a weekend or evening may be higher than the AH funding generated by the locum hours worked. Therefore, the difference would be considered an overhead expense that needs to be paid by ARP physicians.
• Urban practices are required to engage private locums.
• The AMA’s Physician Locum Service supports rural practices in obtaining locum coverage.

Workload

• Physicians determine when and how program services will be delivered.
• The program must submit a proposed typical weekly clinic work/shift schedule as part of the application process.
  Exclusions
• Clinical ARP funding only pays for medically insured services. Lecture-based teaching, practice management, travel, CME, and vacation are not funded.

Reporting Requirements

• As part of the application process, the program proposes approximately five key performance measures (e.g., service volumes, quality measures, physician-patient continuity, etc.).

Ministerial Orders

• Sessional Model Sample COP MO