How many hours did you spend last week on work you could not bill for? I mean the referral follow-ups, the lab reviews, the prescription renewals that slip between appointments.
Starting April 1, 2026, Ontario finally says that time matters. Physicians in eligible FHO models will transition to FHO+, and indirect care and clinical admin will now pay $80 per hour, though total indirect and clinical admin hours are capped at 25% of total billable hours, with clinical admin further limited to 5% of direct plus indirect hours.
But there is a catch. You have to track the time, and you have to meet a 75% continuity of care threshold. Miss that threshold for two related measurement quarters, and you risk a reduction in capitation payments of up to 15% for affected patients. Physicians who miss the mark in a single quarter receive a notification and improvement opportunity before any penalty applies.
Anyone who has worked in healthcare knows the hardest part is often not the medicine; it is proving you did the medicine.
FHO+ feels exactly like that.
What FHO+ Actually Replaces
Under FHO+, the access bonus is eliminated entirely and negation is removed for transitioning physicians. In their place, you get time-based payments for indirect care and clinical administration at $80 per hour, while direct care categories carry their own rates. Patient attachment bonuses also return retroactive to July 2025, now tiered by physician status and RIO score, which offsets part of the lost access bonus income.
The province says physicians will transition by signing the updated FHO contract, with a short rollout period to get used to the new rhythm. That sounds simple on paper, but most clinic software was never built to log billable minutes automatically.
The Ontario Medical Association calls FHO+ the future of family medicine. I agree with the vision. Paying physicians for the full scope of their work, including the invisible hours, makes Ontario competitive for recruiting and keeping family doctors.
The challenge is operational. If you cannot prove you spent twenty minutes on referral coordination, you cannot bill for it. And if your EMR treats that work as invisible, you will leave money on the table every single day.
The Continuity Threshold and the 15% Question
Ontario now measures continuity of care with a wider lens. The measure counts in-basket services for rostered patients, including eligible hospital and long-term care visits tied to your roster.
The magic number is 75%. Fall below it across two related measurement quarters, and you face a potential reduction in capitation payments of up to 15% for affected patients. Physicians who miss the mark in a single quarter will first get a notification and improvement opportunity rather than an instant penalty, which is fair, but only if you know where you stand before the report arrives.
Running a report once a year is not continuity management. It is archaeology. You need weekly visibility into where your patients are landing and who is covering them, or you are managing your practice with last year’s map.
Tracking Time Without Adding Paperwork
This is where clinics get stuck. You cannot claim $80 per hour for indirect care without proof you spent the hour.
Most physicians I talk to in Stoney Creek, Oakville, and Kitchener already work through lunch reviewing results. They just do not write it down. We built OpsMed because that time deserves to be captured, not to replace your MOA, but to stop billable hours from vanishing into the day.
Every OpsMed workflow includes a review-first step. The system might draft a referral summary or log a results review session, but you see it before anything is filed or sent.
We do not make clinical decisions. We organize information so you can make decisions faster.
That distinction matters because your clinical judgment is not negotiable.
For FHO+, we automatically track every billable minute spent on indirect care and clinical admin. No stopwatches.
No manual time sheets. Just an accurate record that belongs to you.
The FHO+ revenue capture module is something no other automation platform offers. AI scribes handle clinical documentation during the visit, and they do that well. OpsMed handles everything else, including fax triage, results routing, referral tracking, and now FHO+ time logging.
If you already use an AI scribe, we complement it. If you do not, we can point you toward options that fit your setup. Either way, your indirect care hours should not be a rounding error.
Your data stays in Canada on Azure Canada Central. Our security backstop includes PHIPA agent agreements, audit logging, and breach response plans built in from day one.
We do not push regulatory boundaries. We want you to sleep well knowing the automation layer is compliant and domestic.
What You Should Do Before April
You will need to sign the updated FHO contract to transition to FHO+. Once that step is complete, the transition handles membership. Your roster and your patients stay with you.
What you do need is a system that captures time and monitors continuity without creating a second job for you or your MOA. April will arrive quickly, and the short rollout period is not a rehearsal. It is go time.
If your current setup requires manual logging or spreadsheet gymnastics to track indirect care, you will face a choice. Either absorb the administrative burden, or leave billable hours on the table. Neither option helps your patients, and neither helps your clinic stay viable.
We started OpsMed in the Golden Horseshoe because we wanted to be neighbors helping neighbors. That means in-person discovery, same-day support during pilots, and an understanding of Ontario’s healthcare reality that you cannot get from a generic platform built elsewhere.
We design every automation with front-desk reality in mind, because we know what actually happens when paperwork delays cascade through a clinic.
I am offering a free Clinic Efficiency Check-Up for Ontario family practices. It is a 20-minute call where we quantify your current admin burden and send you a one-page visual report with quick-win recommendations.
If it makes sense, we can also run a free 30-day pilot for qualifying practices. No gimmicks. Just a chance to see if FHO+ tracking works in your actual clinic before the April deadline starts breathing down your neck.
How much unbilled time walked out of your office today?
Stay safe, Marc
Anyone who has worked in healthcare knows the hardest part is often not the medicine; it is proving you did the medicine.
Explore our clinic automation services or book a free revenue analysis.
Want a free CyberLeda check-up before FHO+ launches?
CyberLeda's free Clinic Efficiency Check-Up quantifies your admin burden and delivers a one-page report with quick-win recommendations to capture every FHO+ billable hour before April.
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