FHO+ Updates for 2025/26: What Ontario Family Physicians Need to Know

FHO+ Updates for 2025/26: What Ontario Family Physicians Need to Know

Ontario’s Family Health Organization (FHO+) model continues to evolve, with several important updates taking effect in 2025/26. These changes reflect the Ontario Medical Association’s (OMA) recent negotiations and arbitration outcomes, introducing new accountability measures, enhanced funding opportunities, and updated billing structures.

Below is a practical summary of the most significant changes physicians and FHO group leads should be aware of this year.

1. Time-Based Billing: New Hourly Limits and Rules

• Daily maximum: Physicians may bill up to 14 total hours per day (direct + indirect combined)
• Monthly maximum: Hours are calculated on a calendar-month basis, prorated from a baseline of 240 hours per 28 days
• Indirect care limit: Up to 25% of total monthly hours may be billed as indirect patient care
• Clinical administration cap: Clinical administrative activities are limited to approximately 5% of total monthly billable time

Rule of thumb: For every 3 hours of direct patient care, up to 1 hour of indirect care may be billed.

2. Continuity of Care (COC): A New Accountability Requirement

• Minimum threshold: 75% continuity (measured quarterly)
• Potential penalty: 15% reduction in capitation payments if performance remains below threshold after improvement window

Expanded acceptable providers include FHO group members, locums, ED/hospital visits, and certain specialists.

3. Patient Attachment Bonuses (Retroactive to July 1, 2025)

   The Patient Attachment Bonus has been reinstated effective July 1, 2025, with retroactive payments expected. Eligibility requires enrolment at the time of the first billable service.

4. Updated FHO Contract and Governance Expectations (Target: April 1)

   Group Leads will coordinate updated contract declarations and governance agreement refreshes.

5. Expanded Leadership Funding (GMLP)

   Enhanced leadership funding may bring total support up to $125,000 for larger groups.

6. After-Hours Premium Increase

   After-hours premium increases from 30% → 50% effective April 1.

How MedPros Can Help
MedPros supports Ontario FHO groups with governance, billing optimization, after-hours planning, locum coordination, and Ministry reporting.

Disclaimer
This article is based on information presented during an Ontario Medical Association (OMA) FHO+ webinar and publicly available materials as of early 2026. Implementation details may evolve. Physicians should rely on official OMA and Ministry sources where discrepancies arise.