Overview of the PAS
Why was the PAS introduced?
PAS is another step in our journey to help revitalize and strengthen family medicine. The objective of the PAS is to better support patients and family physicians by establishing a clear, consistent, and digitally enabled approach to attachment coordination across the province. The PAS reduces the burden on your practice by making the attachment process—when you do have capacity—easier, faster and more efficient. With broad participation, the system provides reliable data which can help to demonstrate attachment trends in our province.
What problems are we trying to solve with PAS?
Here are some of the current challenges we need to address:
- Patients do not have clear guidance on how to find a doctor.
- Physicians and clinic staff are overwhelmed with inquiries from desperate unattached patients.
- Each community has different attachment mechanisms, with inconsistent and different levels of support for patients and providers. Some communities have no attachment programs at all.
- There is incomplete information on clinic and provider capacity to accept new patients.
How will it benefit patients and doctors?
Patients: Will benefit from a coordinated and equitable approach to attachment. It means less worry and confusion, and once capacity is increased, it will be faster and easier to connect with a family physician.
Doctors: Will no longer be inundated with calls from unattached patients desperately seeking a family physician, which is adding to distress levels. You can rest assured that there is a system in place to address the needs of these patients—you will no longer carry that burden alone. The coordinated approach to attachment will significantly help new-to-practice and returning doctors who are building up brand new panels.
For everyone: We need data in order to successfully strengthen our primary care system. Data is the foundational building block to plan for a highly functioning system. As each physician and clinic participates, we will better understand services available in communities and across the province, identify gaps, and measure our progress when solutions are implemented. It will empower communities, regions, and the province to plan more effectively to meet future needs.
Which physicians are expected to participate?
All doctors providing longitudinal care to a panel of patients are asked to participate in the PAS. This includes physicians enrolled in the LFP Payment Model, and those on Fee-for-Service (FFS), and alternate models of payment (for example: group practice contract, population-based funding, AP contract).
Medical directors for clinics with doctors providing longitudinal care are also expected to participate.
Do physicians have a choice in which patients will be attached? Will they be forced to increase their panel size?
Trust and rapport between patients and physicians are critically important and there must be flexibility and choice for both parties.
As such:
- No doctors will be forced to increase their panel size.
- No doctors will be forced to take on new patients.
- The final decision as to whether a new patient is a good match is left with the physician and the patient.
How will physicians and patients be matched?
Attachment coordinators will assist in connecting patients and doctors through the Health Connect Registry (HCR) to ensure there is a good "match”. Should either a physician or a patient decide that the attachment fit isn’t right, the attachment coordinator will return the patient to the HCR to find a better match.
Will physicians be able to accept a patient outside of the PAS?
Yes, physicians can accept patients outside of the PAS. The goal is to attach as many patients as possible with family doctors. It will be important to ensure that you use the 98990 attachment code through MSP/Teleplan to ensure the panel is updated in the PAS to reflect new patients. Information on how to update panel information for new and departing patients can be found in the “Ongoing panel updates following your initial panel submission” section.
What are physicians and medical directors expected to do?
All physicians who provide longitudinal care under the LFP Payment Model, Fee-for-Service, or alternate payment models are asked to:
- Log in to the Panel Registry, provide or update your practice information, and identify whether you are able to take on new patients.
- Clean up panel lists and submit them into MSP/Teleplan using EMRs (if this option is available) or the third-party service provider Dr.Bill. A few days after uploading lists, the data will appear in the Panel Registry.
- Keep your panel information up to date by billing the attachment code for new patients, removing patients through PAS, and periodically reviewing your list of empanelled patients. Starting May 28, 2024, you can see a new ‘MRP Status’ column displayed within the Panel Registry. If you have patients with the Not the MRP status, you may wish to remove them from your panel in the PAS. Once that has occurred, an MRP status of Removed will be displayed.
Clinic medical directors (or designates) must log in to the Clinic and Provider Registry and verify, update, or add information about their clinics.
How do physicians register and access the PAS?
A step-by-step guide on how to register and access the PAS is available.
How will the data collected by the system be used?
Data is one of the foundational building blocks for a high-functioning primary care system. Information within the PAS will help us to:
- Measure system progress.
- Understand which clinics and practices are providing care in a community.
- Empower communities, regions, and the province to plan more effectively to meet future needs. In addition, when we understand current gaps, it means that steps can be taken to address these challenges on a short- or medium-term basis, until longer-term solutions are developed.
- Understand how many and which clinics are accepting new patients.
- Identify gaps in care.
- Have accurate panel information on longitudinal family physicians.
Where can physicians go with questions and for technical support?
Find detailed information for physicians on the PAS. A wide range of training supports and resources can be found on this page under the “Resources and support” headline. A step-by-step guide how to access the PAS is also available.
To access technical support through PHSA:
- Email: HealthBcSupport@phsa.ca
- Join Zoom (link for app/browser and phone/dial in option):
https://zoom.us/j/93003034945?pwd=L3lkL0VqdEJvTjZ2cWMxelB3R3ppdz09
Dial: 1 778 907-2071
Meeting ID: 930 0303 4945
Passcode: 548989
This service is available Monday–Friday 9am–7pm PST, excluding stat holidays.
What will happen to PCNs and divisions that already have patient waitlists?
The Health Connect Registry team is working with communities that may already have a waitlist, such as Divisions of Family Practice or a Primary Care Network, to transfer the list to the Health Connect Registry. In this way, communities will have one centralized list to attach from as capacity is available.
How do I update my panel preferences to indicate that I am accepting new patients?
Under the “My Panel” button within the PAS, there is a section at the top where you can update the Desired Panel Size and Monthly Capacity Rate fields. More information can be found in the Update Panel Preferences and Availability user guide within the PAS.
Panel Registry
Can you provide information on what physicians need to do in the Panel Registry?
All physicians providing longitudinal care need to register and enter or update information in the Panel Registry. You will need a OneHealthID in order to log in. Once you gain access, you will be asked to identify whether you have capacity to accept new patients and how many. If you are not able to accept new patients, you will enter that information.
- You can find a step-by-step guide on how to register and participate in PAS.
Please ensure that you are linked to your clinic as entered into the system by the Medical Director. If you do not see your clinic appear in the dashboard, please speak with your medical director.
If I am new to participating in the PAS am I eligible for the Panel Registry Payment?
Family physicians participating in the Provincial Attachment System (PAS) for the first time who have not previously claimed the one-time Panel Registry Payment:
- Eligible physicians will receive an invitation to claim the payments by early April 2025.
- To be eligible for the $6500 Panel Registry Payment, family physicians must have uploaded their panel and indicated their panel capacity by March 31, 2025.
The deadline to claim this payment is April 27, 2025. If you are unsure about your eligibility, please contact FP.Billing@doctorsofbc.ca.
For more information about the one-time Panel Registry Payment or the Clinic and Provider Registry Payment, please review the FAQs.
I am a physician on a service contract and some of my panel capacity information has been pre-populated in the PAS. Why?
The Ministry of Health pre-populates the “Desired Panel Size” field with the contracted panel size of physicians on service contracts in the PAS. This also automatically updates the “Future Capacity” field which is a formula that displays the difference between a provider’s Desired Panel Size and Actual Panel Size for a clinic. You, or your delegate in the PAS, can change the “Desired Panel Size” field at any time. The “Desired Panel Size” field is the ideal number of patients you would like on your clinic panel.
For more information or support, contact FP.billing@doctorsofbc.ca.
If I am a physician on a service contract and my panel capacity information in the PAS has been pre-populated and is incorrect, what should I do?
You, or your delegate in the PAS, can change the “Desired Panel Size” field at any time. This is the ideal number of patients you would like on your panel.
The “Future Capacity” field is auto calculated based on the difference between your “Desired Panel Size” field and your Actual Panel Size. The Actual Panel Size field changes when:
- you submit your initial list of Empanelled Patients to the PAS,
- you attach a new patient by submitting the 98990 zero-dollar fee code,
- you accept a Transfer Request in the PAS as a receiving physician,
- you remove patients in the PAS, or
- your Transfer Request is accepted by a receiving provider.
Clinic and provider registry
What are medical directors expected to do within the Clinic and Provider Registry?
All medical directors (or designates) at clinics where physicians provide longitudinal care need to log in to the PAS using the BCProviderID, generated on the OneHealthID website.
Step-by-step guide on how to register and participate in the Clinic and Provider Registry.
Once logged in, click on the name of the clinic and verify that all members who require access to the PAS have been added. Next, click the "Clinic Details" tab to verify that the clinic information is correct. If you have other types of clinicians that you work with, add them into the "Other Clinical Staff" tab.
Once all three steps have been completed, the medical director (or designate) has completed all the required tasks. If you have questions and need technical support, please e-mail PHSA: HealthBcSupport@phsa.ca.
If I am new to participating in the PAS is my clinic eligible for the Clinic and Provider Registry Payment?
Clinics participating in the Provincial Attachment System (PAS) for the first time who have not previously claimed the one-time Clinic and Provider Registry Payment:
- Eligible physicians will receive an invitation to claim the payments by early April 2025.
- To be eligible for the $2000 CPR Payment, medical directors must have added or verified their clinic information by March 31, 2025.
The deadline to claim this payment is April 27, 2025. If you are unsure about your eligibility, please contact FP.Billing@doctorsofbc.ca.
For more information about the one-time Panel Registry Payment or the Clinic and Provider Registry Payment, please review the FAQs.
Submitting panel lists
What is involved in submitting lists of empanelled patients?
All longitudinal physicians are expected to submit panel lists to MSP/Teleplan using their EMR or the third-party service provider Dr.Bill. For more information visit the submission webpage. Guides and resources on the Health Technology Resources webpage can help you do this now.
A reminder that full participation in the PAS is an eligibility requirement for CLFP Payments. When a new methodology is developed, panel data will be used to calculate future CLFP Payments to more accurately reflect panel size and complexity. More information on eligibility can be found on the Family Practice Services Committee website.
A note for all physicians: A Facility Number is required to submit a patient panel to your EMR or Dr.Bill. The Facility Number is used to associate the panel with the physician location of the practice. You must apply for and obtain a Facility Number before submitting your patient panel. If you do not have one, you can request one.
Once the panel list is submitted, how long will it take before it appears in the Panel Registry?
The data will appear in the Panel Registry a few days after submitting your panel list.
How do physicians update panel lists once they have been submitted?
How to add patients to panel: Send a $0 attachment code 98990 to MSP/Teleplan through your EMR. This will be reflected in the PAS within a few days. This code and process is only to be used after your full panel is submitted.
If you are adding a patient that you have previously removed from your panel within the PAS, you will need to contact the PAS support team for assistance (contact information).
How to remove patients from panel: Select the patient on your panel and click on the “remove” button in the PAS. Removing a patient in the PAS will not remove them from your EMR, so you will want to ensure the patient has also been removed from your EMR. Work is underway to integrate these systems in the future.
How often should I update panel lists?
We encourage you to incorporate these steps for adding and removing patients into your daily workflow. We also recommend reviewing your panel list in PAS regularly, and no less than on a quarterly basis, to ensure it is up to date and to correct any possible errors along the way. A note that your PAS password will expire after 90 days from logging into the system, so a quarterly check-in will ensure that you do not need to update your password.
You will be able to see panel lists you submitted within a few days of uploading your panel or updates you have made on the Panel Registry through the submission of $0 fee codes. Removal of patients from directly within the PAS is effective immediately.
Why is updating panel lists important?
Updated panels will help everyone involved in primary care have a better picture of attachment in BC, as we work together to ensure people have access to a primary care provider.
As well, updated panel lists in the PAS will be critical to ensure payments accurately reflect panel size when the new method is developed for calculating CLFP payments, or panel payments under the LFP Payment Model.
Sometimes patients appear on more than one panel list. In the PAS we want to ensure as much as possible that patients are only identified on the panel for the FP or NP they visit as their regular source of care. There is now an MRP confirmation process underway, using billing data, to help resolve situations where patients appear on multiple panel lists.
How is the MRP being identified for patients that appear on the panel of more than one physician or NP?
The ministry has been using a process through analyzing MSP data.
- Patients that have had more than five visits and all their visits with a single provider over the past three years will be assigned to that provider.
- Patients that have had fewer than five visits, but where 80% of visits, including their most recent visit, have been with one provider, will be assigned to that provider.
Plans are underway for patients to be contacted to confirm their attachment in situations where the MRP remains unconfirmed after the data analysis is complete. Patients will be able to call 811 or use a new secure patient portal to confirm their MRP.
A new column in the panel registry will identify the patient’s MRP status.
What does “MRP Status” mean in the PAS panel registry?
Starting May 28, 2024, FPs and NPs can see the results of the above process for each patient reflected in a new ‘MRP Status’ column displayed within the PAS Panel Registry. The column will indicate the following:
- Confirmed: The patient is confirmed as attached to the FP or NP (i.e., they are on the panel).
- Not the MRP: The patient is confirmed as attached to a different FP or NP, or the patient has indicated they are not attached to the FP or NP (i.e., they are not on the panel).
- Pending: The patient’s attachment status remains unresolved at this time.
- Removed: The FP or NP has removed the patient from their panel.
In the future, as patients clarify their MRP through 8-1-1 or the secure patient portal, the MRP Status column in the PAS Panel Registry will continue to be updated by the Ministry.
Please note that work is underway for EMR integration with the PAS, with the goal of automating addition and removal of patients in the Panel Registry through EMRs. However, in the interim, FPs, NPs, or their delegates will need to remove patients from the PAS Panel Registry manually.
Can panel uploads and PAS tasks be completed by my MOA or my director?
While you can allow your MOA or director to manage your panel and profile in the future, you first need to complete the panel upload and the required steps within the PAS. Learn about the steps.
How do I transfer my panel to my new clinic?
Physicians can use the PAS to transfer patients from their panel to another physician or nurse practitioner. This benefits physicians who may be retiring, leaving a clinic, or simply need to transfer a patient to another physician. It will also make it faster and easier to transfer when a patient appears on an incorrect panel in the PAS. Details on this process can be found in a previous newsletter.
How do I transfer my panel to another physician?
Family physicians are able to use the Provincial Attachment System to transfer patients from their panel to another physician, or from one clinic to another. This will benefit physicians who may be retiring, leaving a clinic, or simply need to transfer a patient to another physician. It will also make it faster and easier to transfer patients when they appear on an incorrect panel list.
- The Panel Transfer tab can be found on the PAS Home page, or on the My Panel page.
- The physician who is sending a request for their patient to be transferred will need to use the receiving physician’s MSP Practitioner Number.
- The receiving physician can either accept or decline the request(s) on a patient-by-patient basis.
- Any number of patients can be transferred at one time. If a physician would like to transfer only a few patients, they can search for them by name or by using their Personal Health Number (PHN). There is also an option to transfer an entire panel at one time.
- Physicians can delegate to non-clinical staff by completing the endorsement process.
Can I submit my panel in batches?
Your panel should be submitted all at once. This is a one-time process. After submitting panel lists to MSP/Teleplan through your EMR or Dr.Bill, they will show up in the PAS within a few days. It is important to keep your Panel Registry in PAS up to date and in line with your EMR on an ongoing basis. Learn more about this under the “Ongoing panel updates following your initial panel submission” section.
I am on the LFP payment model and submitted my panel already. Do I need to submit my panel again for the PAS?
As long as you submitted your panel through your EMR (if supported) or Dr.Bill, you will not need to resubmit.
Is a Facility Number needed for non-LFPs panel upload?
Yes. The Facility Number is important when uploading your panel and is used to associate the panel with the physician’s location practice. This will allow your panel to appear within your clinic on the PAS. If you do not have a Facility Number, you can request one. If you practice at more than one location, you will need a Facility Number for each one.
If I joined the PAS after March 31, 2024, can I apply for the Panel Registry Payment or the Clinic and Provider Registry Payment?
Family physicians and clinics participating in the Provincial Attachment System (PAS) for the first time who have not previously claimed the one-time Panel Registry Payment or the Clinic and Provider Registry Payment will be eligible to apply for the following payments starting in early March 2025.
Please see our recent newsletter for more information.
What should I do if a patient in my panel is listed as ‘Pending’?
If a family physician is certain that they provide longitudinal care for the ‘Pending’ patients on their panel in the PAS, they can resubmit the 98990 $0 fee code. This will confirm their role as the Primary Care Provider.
What should I do if there’s patients on my panel where their MRP status has changed to ‘Not the MRP’?
These are patients that have been confirmed on another provider’s panel. If the physician is confident they provide longitudinal care to a patient but the patient’s status continues to show “Not the MRP” in the PAS, they can resubmit the 98990 $0 fee code to confirm their role as Primary Care Provider. A reminder to make this update in the EMR, and to update your capacity field in the PAS. If uncertain about a patient’s status, physicians can ask the patient to call 8-1-1 to confirm their Primary Care Provider.
Please go to the PAS for more detailed information.
If I am a physician on a service contract and my panel capacity information has been pre-populated, should I still upload my panel into the PAS?
Yes, by submitting your panel list to the PAS, the “Actual Panel Size” field is updated. This affects the auto-calculated “Future Capacity” field, which is based on the formula “Desired Panel Size” minus “Actual Panel Size”.
There are two ways for physicians to submit panel lists:
- through your EMR if you use MedAccess, Profile, Accuro, or MOIS, and
- through the third-party billing service provider, Dr.Bill, which is provided at no cost.
You should only submit your entire panel as a bulk upload one time. Please refer to the ongoing panel updates following bulk upload document for workflow considerations to keep your PAS panel list accurate and updated.
Accelerated attachment through the PAS
What steps are being taken to accelerate patient attachment?
A number of enhancements have been made to the Provincial Attachment System (PAS) and the Health Connect Registry (HCR) that will streamline and accelerate patient attachment while reducing the burden on physicians:
- A new system to prioritize patient attachment that includes the ability for patients to provide information on any changes to their health within the HCR.
- Improvements to the PAS that provide ‘end to end’ supports so that, for the first time, physicians can use the PAS to request, select, and confirm attachment of patients online.
The objective of PAS has always been to better support patients and FPs/NPs by establishing a clear, consistent, and digitally enabled approach to attachment coordination across the province. This is one of the next steps in the process.
What are the factors that will determine priority for attachment?
- Complexity: Clinical administrative data available to the Ministry will be used to calculate complexity (high/medium/low) of the patients’ care needs.
- Stability/New and Recent Diagnoses: Patients will be given the opportunity both at initial registration, and on an ongoing basis, to provide information about their health status either by telephone or online. This may be particularly important for people with new/recent changes to their health status or for people who may be new to the province and whose medical information is not yet available in our administrative data.
- Time on Registry: Consideration will be given to the length of time people have been on the Health Connect Registry list.
What is the definition of high, medium, and low complexity?
Complexity of patients’ needs is one of the factors that will be considered in prioritizing patients for attachment. The categories are defined as follows:
High complexity:
Patients with expected highest need and urgency based on age, diagnostic history (diagnoses, combination of diagnoses, expected duration of diagnoses) and health system utilization.
Medium complexity:
Patients with complex health conditions but who do not have the highest need and urgency for immediate attachment to remain stable.
Low complexity:
Patients with potentially complex health conditions but who do not have the highest need and urgency for immediate attachment to remain stable OR unknown (no data yet available in BC).
How were these definitions developed?
Two methodologies were used:
Adjusted Clinical Groups (ACG) - ACG is derived from diagnostic codes submitted to the Ministry of Health, either through MSP billings or hospital records. It considers diagnoses, expected duration and intensity of healthcare resources, severity, diagnostic certainty, age and sex in its complexity scoring.
John Hopkins and Resource Utilization Bands (RUB) - ACG disease groupings are combined with MSP utilization data to generate RUB. RUB includes six categories ranging from non-users and healthy users to patients with very high morbidity.
What will these changes mean for physicians?
Attachment Coordinators will use the new data to recommend a list of patients for possible attachment with physicians who have capacity to expand their panels, taking into account complexity, any recent changes, and length of time on the Health Connect Registry.
Physicians will be able to build a panel with varying degrees of complexity and health care needs. For the first time, physicians will be able to receive, select, and attach patients entirely through the PAS.
How will the process work for physicians?
Practitioner Capacity:
Practitioner advises capacity (if accepting, and max # patient request) in Panel Registry
+
Patient Selection:
Practitioner receives notification an attachment coordinator has recommended patients for consideration, and selects patients for intake in Panel Registry > Pending Selection
+
Patient Intake:
Practitioner completes intake for selected patients, and confirms successful (or not) attachment in Panel Registry > Pending Intake
=
Attached:
Practitioner views list of accepted patients following intake in Panel Registry > Accepted
What happens if a patient is not selected?
If the patient is not selected, they will remain on the Health Connect Registry until a suitable match is found. Later this year, the Ministry will start directing complex, high needs patients to interim, virtual supports while waiting for attachment.
Access the detailed FAQ PDF that includes much more information on deadlines and process.
What happens when I add a new patient to my panel?
When a new patient is added to a family doctor’s panel, they can bill 98990 $0 fee code to confirm their role as Primary Care Provider. The patient’s MRP Status will be ‘Confirmed’ on the physician’s panel.
Have additional questions?
If, after reviewing the FAQs, you have additional technical support questions, please email PHSA: HealthBcSupport@phsa.ca.