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Blended Capitation Model Frequently Asked Questions Example for Clinics

This document contains sample questions and answers to patient questions about the BCM model. This content can be included on your clinic website.
It is provided as a guide only. Please customize this information for your clinic’s needs.

Sample BCM FAQ questions

Q: WHAT IS THE BLENDED CAPITATION MODEL?
A: (insert clinic name) has entered into a new team-based model with Alberta Health – the Blended Capitation Model. This is essentially a flip on the way the physicians are compensated for their patient panels. Rather than being compensated on an “as seen” basis, the clinic is provided funds based on their patient population instead. 

This model allows for patients to see a variety of health professionals within our office, which allows physicians to spend more time in a visit managing health and wellness proactively. A great benefit of this model is that we will be able to expand our care team and improve our availability. Our care delivery is based on health teams working together to provide thorough, consistent, and comprehensive patient-centered care.

What does this mean to you? 
Instead of seeing a doctor at every visit, you may (for example) see a (insert IDT role), (insert IDT role), or (insert IDT role) .

More details on the Blended Capitation Model can be found here

Q: WHAT CHANGES FOR ME
A: Nothing! Other than receiving even better care!

We will strive to have more appointments available as we are able to expand our team. We already have excellent availability, however by expanding our team as well as being able to offer more virtual options (for simple things like prescription refills and results), we endeavor to always be able to offer our affiliated patients same-day or within one-day care when needed. 

We also ask that you contact us FIRST when you need to receive care (instead of going to a walk-in clinic). Unless you are in a medical emergency - in that event call emergency services and/or go straight to the emergency room. 

Q: ARE THERE ADDITIONAL FEES OVER AND ABOVE ALBERTA HEALTHCARE?
A: No. There will be no additional fees for this change; your healthcare continues to be covered by the provincial Alberta Health Care (AHC) Insurance Plan.

There are still services we provide that are not covered by AHC which may require payment (e.g., Driver’s Medicals, Insurance Forms, missed appointment fees). 

Q: I LIVE IN BRITISH COLUMBIA - HOW DOES THIS AFFECT MY CARE?
A: The BCM applies to our Alberta patients ONLY.

We are funded by, and have an agreement with, Alberta Health. For out-of-province patients that are seen in clinic, we can continue to see you, however we will continue to submit claims to the province of British Columbia.

(PLEASE NOTE: Out-of-province visits must be in-person only! Physicians are not able to provide regular, virtual care to those residing outside of Alberta for reasons of medical liability).

Q: DO I NEED TO MAKE AN APPOINTMENT TO SIGN THE FORM?
A: No. You can sign the form at your next appointment.

If you don’t have an appointment booked, you don’t need to book one just to sign the form. You can stop into the clinic at any time and speak with our reception staff to request the form.

Alternately, you can click HERE (link to a downloadable form on the clinic website) for a copy of the form to print, complete and return to clinic in person.

Q: WHAT HAPPENS IF I CHOOSE NOT TO SIGN AN AFFILIATION FORM?
A: If the form is not signed, we would reach out to you to confirm whether you intend to stay on as a patient with us at (insert clinic name).

If you choose not to sign an affiliation form, you would be confirming that you do not want to continue being a patient at (insert clinic name). After that, under certain circumstances, we could provide you with care up to two times in a two-year period. 

Q: DO MY CHILDREN UNDER 18 NEED TO HAVE AN AFFILIATION FORM SIGNED, AND AS THEIR PARENT CAN I SIGN ON THEIR BEHALF?
A: Yes. 

Every patient will need to have a completed affiliation form. Parents can sign for their children under the age of 16. 

Q: I AM A CAREGIVER/LEGAL GUARDIAN/DECISION MAKER FOR A PERSON OVER THE AGE OF 18, DO I NEED TO COMPLETE AND SIGN THE AFFILIATION FORM ON THEIR BEHALF?
A: Yes. 

You will need to complete and sign the affiliation form, and you may have to provide proof that you can legally act for this individual (under section 104 of Alberta’s Health Information Act) if we don’t already have a copy of proof on file. 

Q: I am signing a written commitment to contact you first for medical needs. However, if I’m traveling WITHIN ALBERTA  and need medical care, am I prevented from visiting a walk-in clinic?
A: We are committed to providing care to our patients in need.

If you are out of town and need care, we may be able to provide that to you virtually (via telephone). There are many things our team can manage via telephone. If you’re not sure, please call the clinic to ask and we can help guide you (or book a telephone appointment online via your patient portal). Of course, we realize that some needs cannot be dealt with over the phone and at times, patients will need to receive care elsewhere. You will not be financially penalized.

One of the requirements of this new model is to clearly identify who are patients of our clinic. This is done by having each patient sign an affiliation form. By signing this form you will be attached to (insert clinic name) and agree to contact us first for your medical needs (before going to a walk-in clinic). This also means that if you access primary care elsewhere (i.e. a walk-in clinic) we are notified, and this pulls funds and resources away from your Medical Home.

Every possible opportunity to provide care for you at the (insert clinic name) will be made available to ensure you can be seen as needed. We recognize that urgent medical needs will arise and, as always, emergency room visits remain available to you.

TO BE CLEAR - if you find yourself in a medical emergency, don’t hesitate – contact emergency services and/or go straight to an emergency room for treatment. 

Q: I WAS REFERRED TO A SPECIALIST. CAN I STILL GO TO THAT APPOINTMENT?
A: Yes! 

We only encounter an issue if you see a “general practitioner” (family doctor) at another clinic. We strongly encourage you to attend any appointments that require a referral. 

In addition to physician-specialists (for example: dermatologists, gastroenterologists, neurologists, etc.), you are still welcome to receive care from any physiotherapist, chiropractor, naturopath, pharmacist or acupuncturist of your choice, as they are not classified as a family doctor. 

Q: WHAT IS “CONTINUITY OF CARE” AND WHY DOES IT MATTER TO ME?
A: Continuity of Care is when a patient consistently sees the same primary care team.

It involves improving patient health through stronger, ongoing relationships with their primary care team, increased information sharing amongst the team, and enhanced care coordination.

Having a good relationship with a primary care team (i.e,: US! Your [insert clinic name] team) and being strongly “attached” to a family doctor benefits your health in a number of ways. It means seeing your primary care team whenever it is possible.

When your primary care team is always your go-to for health concerns, they are aware of all your health issues and can help you make more informed decisions about your health. 

A high level of Continuity of Care results in: 

  • Increased patient satisfaction
  • Increased health care screening
  • Increased efficiency of diagnosis
  • Improved outcomes of chronic disease
  • Decreased emergency room visits
  • Decreased hospital admissions
  • Decreased diagnostic test rates
  • Decreased prescription rates


Q: I HAVE A FAMILY MEMBER OR FRIEND THAT NEEDS A FAMILY DOCTOR, CAN THEY GET IN TO XX CLINIC AS A NEW PATIENT?
A:
 Insert clinic response