The Joint Standing Committee on Rural Issues (JSC), a partnership of Doctors of BC and the BC government, has announced significant changes to the Rural Retention Program (RRP) that will increase eligibility for incentives and benefits and stabilize funding to better recruit and retain physicians into practices in rural communities. The RRP offers incentives and benefits to encourage doctors to establish and maintain practices and connections in rural communities. The program is designed to enhance the supply and stability of physicians in rural communities as defined by the Rural Subsidiary Agreement (RSA). The changes reflect feedback from extensive consultations with rural physicians, communities, and health authorities as part of a review of the program. This completes the first phase of the review.
Recognizing that the eligibility criteria had been largely unchanged since the program started nearly 20 years ago, the JSC undertook a comprehensive 3-year review of the RRP starting in August 2018. Facilitated by the Rural Coordination Centre of BC, nearly 600 rural physicians were consulted via facilitated dialogue, webinars, and a provincial survey. In addition, medical and administrative leaders in each rural health authority, community groups, subject matter experts, and other partners were consulted to develop recommendations.
Feedback included suggestions to address the annual fluctuation of rural points in some communities, to ensure the RRP remains a relevant incentive program including coverage for medical or parental leaves, and to create equity with the business cost premium.
The JSC agreed to hold the points constant while it conducted the review.
Changes to the Rural Retention Program
Effective 1 April 2021, the changes are:
- A temporary reduction of the RRP income eligibility threshold. The JSC recognizes that COVID-19 has impacted professional practice. To broadly support physicians whose income may have been impacted, the income requirement for eligibility of the RRP flat fee in 2021/22 has been reduced from $75 000 to $65 000.
- New and retroactive eligibility for physicians on parental leave or planning medical leave are available. Until now, physicians on parental or medical leave were not eligible to receive RRP payments. To support physicians to stay in the community, the changes mean that physicians will be eligible for the RRP flat fee payment and their earned RCME benefit for a period of 12 months, effective retroactively to 1 April 2020.
- The Rural Business Cost Modifier (RBCM) is being introduced to support physicians who reside and practise in rural communities. This change aligns payments to rural physicians with doctors in urban areas who are eligible for the business cost premium payments as per the recent Physician Master Agreement. An increase will be added to rural physicians’ RRP flat fee payment disbursed through the health authority on behalf of the JSC.
- The minimum point threshold to be eligible for full rural benefits has been reduced from 6.0 to 1.5 points. The communities falling between 1.5 and 14.99 points will now be considered “C” designated communities and will be eligible for those benefits. This means that more communities will be eligible for RRP payments for their physicians, and they will be able to continue to receive other benefits under the RSA.
- To help mitigate year-to-year variations and uncertainties, and to appropriately stabilize the community points, the JSC will now implement point assessments using a five-year rolling average. This will ease the year-to-year fluctuations, stabilizing payments and benefit levels in communities.
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