The Ontario Medical Association says the agreement was accepted by 81 per cent of the nearly 21,000 doctors who voted by phone or online.
The OMA says the deal, worth $11.1-billion a year, will trim spending by $400 million through a half a per cent payment cut for all doctors while "modernizing" how services are delivered.
But Health Minister Deb Matthews has said total payments to physicians will rise by $100 million as new doctors are brought on, an increase that will be offset by cost savings.
The changes to services include shortening the length of time of annual physicals and the number of tests done on healthy adult patients.
The OMA says the agreement, effective from last Oct. 1 until March 31, 2014, will pump new money into house calls to seniors and high-need patients.
It also says the deal announced Sunday will let patients speak to doctors more easily through "e-consultations."
A tentative agreement was reached last month after the two sides returned to the bargaining table following a dispute this year over regulatory changes to cut Ontario Health Insurance Plan fees and premiums.
The deal shows doctors can work with the Liberal government as it moves to tame the deficit, said OMA President Dr. Doug Weir.
"Ontario's doctors demonstrated tremendous leadership by being active partners in helping the province with its fiscal challenges," he said in a release.
"If we are going to build on our successes in recent years to improve health care in Ontario, doctors and government need to continue to work in partnership."
Matthews called the ratification an "important milestone" for the province's health care system.
"Ontario's doctors have demonstrated real leadership today. They worked with us to find creative solutions under challenging fiscal circumstances," she said in a statement.
"This agreement marks a renewed era of partnership with doctors as we work together to transform and sustain our precious health care system."
Also on HuffPost