Converting to an APP

Converting to an APP

Physicians who are converting from a fee-for-service contract to an APP contract usually follow the steps below.

Indicate interest

The first step is to notify the appropriate Nova Scotia Health Authority (NSHA) department head of your interest in converting to an APP and seek their endorsement. Next, you will meet with the NSHA, the Department of Health and Wellness (DHW) and Doctors Nova Scotia (DNS) to discuss the conversion potential.

Analyzing billings

The DHW will then analyze your practice billings over the last three years to assess whether or not a funding differential may exist. This analysis will include all physicians in the group who intend to convert, as well as any locums who might have worked during that period or physicians who retired or left and were not replaced.

FTE allocation

Once the billings analysis is complete, the DHW will assign your practice a full-time equivalent (FTE) allocation. In some cases, the FTE allocation is not reflective of actual practice. If that occurs, there will be further discussion and negotiation until the NSHA, DHW and the physician come to an agreement about potential adjustments.

Negotiating deliverables

Once the conversion is approved and all parties are in agreement with the FTE allocation, you will work with the NSHA – with support from DNS – to negotiate your deliverables agreement. Deliverables are developed based on a defined set of parameters that have been negotiated between DNS, the NSHA and DHW. 

If you need assistance negotiating your unique practice deliverables, please contact your DNS physician advisor.


Jennifer Girard
Physician advisor (Zone 4-Central)
Ryan Brown
Physician advisor (Zones 2-Northern and 3-Eastern)