| Characteristic | Enhanced fee-for-service model | Capitation model |
|---|---|---|
| Patient enrolment | Optional | Required |
| After-hours call | Required | Required |
| Fee-for-service payment | Full payment plus 10% premium for 21 comprehensive care services | Payment at 10% of full rate for 56 services for enrolled patients; established maximum fee-for-service payments annually |
| Extended hours | One 3-hr evening or weekend session per physician per wk, to a maximum of 5 sessions; exempted if > 50% of physicians provide emergency, anesthesia or obstetrics coverage | Same as enhanced fee-for-service model |
| After-hours care | Additional 20% of fee-for-service payment for enrolled and virtually enrolled patients for 9 basic office services | Same as enhanced fee-for-service model |
| Access bonus | NA | Additional payment, reduced if enrolled patient sees an nonspecialist physician outside of group |
| Group management and leadership | NA | Annual fee per enrolled patient |
| Management of care for heart failure | Annual fee per enrolled patient for coordinating, providing and documenting required elements of care for heart failure | Same as enhanced fee-for-service model |
| Unattached patient fee | A one-time fee for enrolling an acute care patient without a family physician following discharge from an inpatient hospital stay | Same as enhanced fee-for-service model |
| New patient premium | A one-time fee for up to 60 enrolled new patients without a family physician; increase in fee for patients aged 65–74 yr, and a further increase in fee for patients aged 75 yr and over | Same as enhanced fee-for-service model |
Note: NA = not applicable.