What are the eligibility requirements and required practice commitments?

What are the eligibility requirements and required practice commitments?

This is a joint project between Doctors Nova Scotia and the Nova Scotia Department of Health and Wellness.

What are the eligibility requirements and required practice commitments?

  • Minimum practice eligibility requirements: To be eligible to participate in this pilot project, the following minimum practice requirements must be met:
    • Minimum of four family physicians per practice
    • All physicians within the practice must use a shared electronic medical record (EMR)
    • Clinic must be willing to open for evening/weekend coverage
    • All physicians working in the practice must commit to participating in the pilot
  • Current payment model: Pilot practices can be either fee for service or APP (or a mixture of the two) if other project parameters are met. 
  • Co-location: Physical co-location is not required but is preferred. Patients must have access to in-person care.
  • Rostering existing patients: Practices should be well established (in place for three or more years) to ensure an existing patient roster to support this payment model. However, participating physicians do not all have to have been in practice for that time. All patients on the physician’s panel will be rostered to the practice. Patients will be encouraged by the physician and/or practice staff to visit the clinic for all primary health care needs because they are better served by having a medical home.
  • De-rostering patients: De-rostering patients during the pilot project is strongly discouraged except in extenuating circumstances (such as patients who move away, abusive behaviour, etc.). As always, practices discharging a patient must follow the guidelines on Ending the Physician-Patient Relationship by the College of Physicians and Surgeons of Nova Scotia. Patients may choose to leave the practice at any time.
  • Rostering unattached patients: Physicians are encouraged to collaborate to develop a plan to roster additional patients to the practice. Practices are encouraged to have an average panel size of 1,350 patients per physician. Pilot project administrators will work with practices on achieving this target. New patients should, whenever possible, be taken from the 811 Need a Family Practice Registry to increase their panel size. 
  • Standard of care: Physicians must ensure they maintain quality of care, accessibility, patient satisfaction and comprehensive services, including access for patients who are not on their panel but are rostered to the practice.
  • Clinical hours: Practices must provide minimum office hours as follows:
    • 7.5 hours per weekday during core hours of 8 a.m. to 5 p.m.
    • 13 hours per week outside of core hours, which includes:
    • 10 hours on weekdays between the hours of 5 to 9 p.m. (four weekdays at approximately 2.5 hours each)
    • 3 hours on the weekend
  • Draft practice plan: Practices must submit a draft practice plan as part of their expression of interest demonstrating how physicians will meet the needs of their own panel and patients of the practice. Modifications may be made in consultation with pilot project administrators. The practice’s evening/weekend hours must be regularly scheduled and clearly communicated to patients of the practice.
  • Physician leave: Practices are encouraged to manage and coordinate time-off within their group for short-term leaves when possible. Practices that are otherwise eligible to access the Provincial Locum Program can arrange locum coverage for short- and long-term leaves when cross-coverage within the practice is not possible.