Medical Services Plan

MSP Information Resource Manual Fee-For-Service Payment Statistics

2019/2020

Health Sector Information, Analysis and Reporting Division If you have any questions about the information presented, please contact the Business Services & Transformation (BST) branch of the Health Sector Information, Analysis and Reporting (HSIAR) Division Ministry of Health

All inquiries may be directed to the central intake team at the following email address: [email protected]

How to Cite This Document B.C. Ministry of Health, Health Sector Information, Analysis & Reporting Division. MSP Information Resource Manual 2019/2020. October 2020. Table of Contents

Preface ...... 7 Introduction ...... 8 Methodology ...... 9

A. GEOGRAPHIC HEALTH GROUPINGS ...... 10

British Columbia Health Authorities Map ...... 11 British Columbia Health Service Delivery Areas Map ...... 12 British Columbia Local Health Areas Map ...... 13 Listing of Health Authorities, Health Service Delivery Areas and Local Health Areas ...... 14

B. PRACTITIONER DATA ...... 15

1. Total Number of Practitioners, Services and Expenditure by Specialty, B.C. Table 1-1 2019/2020 ...... 16 Table 1-2 2018/2019 ...... 18 Table 1-3 2017/2018 ...... 19 Table 1-4 2016/2017 ...... 20 Table 1-5 2015/2016 ...... 21

2. Total Number of Practitioners, Services and Expenditure by Specialty, by Health Authority, 2019/2020 Table 2-1 1-Interior...... 22 Table 2-2 2-Fraser ...... 23 Table 2-3 3- Coastal ...... 24 Table 2-4 4-Vancouver Island ...... 26 Table 2-5 5-Northern ...... 28 Table 2-6 Unknown Health Authority ...... 29

3. Total Number of Practitioners, Services and Expenditure by Specialty, by Health Service Delivery Area, 2019/2020 Table 3-1 11-East Kootenay ...... 30 Table 3-2 12-Kootenay Boundary00 ...... 31 Table 3-3 13-Okanagan ...... 32 Table 3-4 14-Thompson/Cariboo ...... 33 Table 3-5 21-Fraser East ...... 34 Table 3-6 22-Fraser North ...... 35 Table 3-7 23-Fraser South ...... 36 Table 3-8 31-Richmond ...... 37 Table 3-9 32-Vancouver ...... 38 Table 3-10 33-North Shore/Coast Garibaldi ...... 40 Table 3-11 41-South Vancouver Island ...... 41 Table 3-12 42-Central Vancouver Island ...... 42 Table 3-13 43-North Vancouver Island ...... 43 Table 3-14 51-Northwest ...... 44 Table 3-15 52-Northern Interior ...... 45 Table 3-16 53-Northeast ...... 46 Table 3-17 Unknown Health Service Delivery Area ...... 47

4. Distribution of Practitioners by Expenditure Range, B.C. Table 4-1 2019/2020 ...... 48 Table 4-2 2018/2019 ...... 50 Table 4-3 2017/2018 ...... 51 Table 4-4 2016/2017 ...... 52 Table 4-5 2015/2016 ...... 53

5. Population, Practitioners, Services and Expenditure, 2019/2020 Table 5-1 Health Authority ...... 54 Table 5-2 Health Service Delivery Area ...... 55 Table 5-3 Local Health Area ...... 56

6. Services and Expenditure by Service Code Table 6-1 2019/2020 ...... 58 Table 6-2 2018/2019 ...... 60 Table 6-3 2017/2018 ...... 62 Table 6-4 2016/2017 ...... 64 Table 6-5 2015/2016 ...... 66

C. REGISTRANT & PATIENT DATA ...... 68

7. Medical Services Plan Registrants, 20142016 - 2019/2020 Table 7-1 Health Authority and Gender ...... 69 Table 7-2 Health Service Delivery Area and Gender ...... 70 Table 7-3 Age Group and Gender ...... 71

8. Medical Services by Health Authority and Gender, 2015/2016 - 2019/2020 Table 8-1 Patient Counts...... 72 Table 8-2 Services ...... 73 Table 8-3 Expenditure ...... 74

9. Medical Services by Health Service Delivery Area and Gender, 2015/2016 - 2019/2020 Table 9-1 Patient Counts...... 75 Table 9-2 Services ...... 76 Table 9-3 Expenditure ...... 77 10. Medical Services by Age Group and Gender, 2015/2016 - 2019/2020 Table 10-1 Patient Counts ...... 78 Table 10-2 Services ...... 79 Table 10-3 Expenditure ...... 80

11. Medical Services by Specialty and Gender, 2015/2016 - 2019/2020 Table 11-1 Patient Counts ...... 81 Table 11-2 Services ...... 83 Table 11-3 Expenditure ...... 85

12. Medical Services by Service Code and Gender, 2015/2016 - 2019/2020 Table 12-1 Patient Counts ...... 87 Table 12-2 Services ...... 88 Table 12-3 Expenditure ...... 89

13. Other Health Practitioner Services by Health Authority and Gender, 2015/2016 - 2019/2020 Table 13-1 Patient Counts ...... 90 Table 13-2 Services ...... 91 Table 13-3 Expenditure ...... 92

14. Other Health Practitioner Services by Health Service Delivery Area and Gender, 2015/2016 - 2019/2020 Table 14-1 Patient Counts ...... 93 Table 14-2 Services ...... 94 Table 14-3 Expenditure ...... 95

15. Other Health Practitioner Services by Age Group and Gender, 2015/2016 - 2019/2020 Table 15-1 Patient Counts ...... 96 Table 15-2 Services ...... 97 Table 15-3 Expenditure ...... 98

16. Other Health Practitioner Services by Specialty and Gender, 2015/2016 - 2019/2020 Table 16-1 Patient Counts ...... 99 Table 16-2 Services ...... 100 Table 16-3 Expenditure ...... 101

17. Other Health Practitioner Services by Service Code and Gender, 2015/2016 - 2019/2020 Table 17-1 Patient Counts ...... 102 Table 17-2 Services ...... 103 Table 17-3 Expenditure ...... 104 D. GENERAL PRACTICE SERVICES COMMITTEE & SPECIALIST SERVICES COMMITTEE INITIATIVES ...... 105

18. General Practice Services Committee and Specialist Services Committee Initiatives Table 18-1 General Practice Services Committee Initiatives, 2015/2016 - 2019/2020 ...... 106 Table 18-2 Specialist Services Committee Initiatives, 2019/2020 ...... 107 Table 18-3 Specialist Services Committee Initiatives, 2018/2019 ...... 108 Table 18-4 Specialist Services Committee Initiatives, 2017/2018 ...... 109 Table 18-5 Specialist Services Committee Initiatives, 2016/2017 ...... 110 Table 18-6 Specialist Services Committee Initiatives, 2015/2016 ...... 111

GLOSSARY ...... 112 7

Preface

The Medical Services Plan (MSP) Information Resource Manual 2019/2020 is produced by the Health Sector Information, Analysis and Reporting Division. It provides a reference for some of the most frequently asked questions about MSP data including practitioner, patient and registrant fee-for-service statistics.

Related publications on MSP data are the MSP Fee-For-Service Payment Analysis 2015/2016 - 2019/2020 and the MSP Physician Resource Report 2010/2011 - 2019/2020.

All three reports can be found online at this address under Fee-for-Service Payment Statistics: http://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/msp/publications.

Questions, comments or suggestions regarding this report may be directed to [email protected].

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Introduction

Under the authority of the Medicare Protection Act, the Medical Services Commission administers MSP. MSP insures registrants for medically required services provided by general practitioners, specialists and other health practitioners. MSP pays practitioners on a fee-for- service and on an alternative payment basis.

The Information Resource Manual contains statistics based on fee-for-service payments made to British Columbia practitioners by MSP for services provided to MSP registrants.

The manual is arranged in four major sections: A. British Columbia Geographic Health Groupings: contains maps and a listing of health authorities, health service delivery areas (HSDA), and local health areas (LHA); the relationship between health authority, HSDA and LHA is demonstrated in this section. B. Practitioner Data: presents data on expenditure and paid services by specialty, service code and geographic area. C. Registrant & Patient Data: presents data on expenditure and services provided with breakdowns by patient gender/age and geographical area. D. General Practice Services Committee Initiatives & Specialist Services Committee Initiatives: presents data on expenditure and services for practitioner initiatives by specialty.

The Methodology section that precedes sections A to D outlines general data inclusions and exclusions that apply throughout the manual. Additional methodology details are provided at the beginning of sections A, B, C and D.

A glossary has been provided at the end of the manual to explain terms used in the publication. Readers are encouraged to refer to the glossary to ensure accurate interpretation of the statistics presented.

This publication is prepared using specific criteria and therefore may not reconcile with other Ministry of Health documents such as the Medical Services Commission Financial Statements.

To maintain confidentiality, the information given does not disclose personally identifiable data.

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Methodology

The data used to generate statistics in this manual include MSP fee-for-service payments made to general practitioners, specialists and other health practitioners for insured services provided to MSP registrants. Only services performed in a given fiscal year (April 1st to March 31st) and paid on or before September 30th of the following fiscal year are included.

The general data inclusions and exclusions applied throughout the manual are listed below. Additional methodology details are provided at the beginning of sections A, B, C and D.

General Data Inclusions

• Expenditures paid for by MSP, including the adjudicated fee schedule amount, retroactive payments, rural retention program payments and tray fees • Expenditures paid to physicians for services referred by registered midwives or nurse practitioners • With the implementation of the Laboratory Services Act on October 1, 2015, fee item values are based on the new Fee-For-Service Outpatient Laboratory Services Payment Schedule and are subject to change by the Minister of Health • Expenditures for General Practice Services Committee initiatives and Specialist Services Committee initiatives are reported in section D only

General Data Exclusions

• Interest on late payment of claims • Services associated with the following service codes as these are charges in addition to the principal fee: o 09 - General Practice Visit Premiums* o 19 - No Charge Referral o 49 - Procedural Premiums* o 71 - Tray Fees* • Alternative payments made for contract, salaried, session and other services • Payments for services performed out of province

* Billings are included in the Total Expenditure statistic but are not counted as services to avoid double counting of services.

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A. British Columbia Health Boundaries

British Columbia (B.C.) is divided into five regional health authorities that are responsible for planning and delivering health care services within their geographic areas:

1. Authority 2. Authority 3. Authority 4. Vancouver Authority 5. Authority

Each health authority consists of three or four Health Service Delivery Areas (HSDAs). There are 16 HSDAs in total. The HSDAs are further divided into 89 Local Health Areas (LHAs).

B.C. has two other health authorities that are not defined by geographic boundaries.

The Provincial Health Services Authority is responsible for governing and administering provincial programs and highly specialized services, such as those delivered by the Children’s and Women’s Health Centre, the B.C. Cancer Agency and the B.C. Transplant Society.

The First Nations Health Authority is responsible for the programs and services formerly managed by Health Canada’s First Nations Inuit Health Branch – Pacific Region.

Only data for the five regional health authorities are reported in this manual. Health authority, HSDA and LHA maps can be found on the following pages.

More information on B.C.’s health authorities can be found here: http://www2.gov.bc.ca/gov/content/health/about-bc-s-health-care-system/partners/health- authorities.

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British Columbia Health Authorities

NORTHWEST TERRITORIES Health Authorities 1 Interior (IHA) 2 Fraser (FHA) 3 Vancouver Coastal (VCHA) 4 Vancouver Island (VIHA) 5 Northern (NHA) 1. Nisga'a is a separate governance health board YUKON

FortFort NelsonNelson

5 NorthernNorthern FortFort St. John StewartStewart DawsonDawson Creek

1 MackenzieMackenzie NewNew HazeltonHazelton TumblerTumbler RidgeRidge ALBERTA Nisga’a SmithersSmithers TTerraceerrace HoustonHouston FortFort St.St. JamesJames PrincePrince Rupert KitimatKitimat PPrincerince George VanderhoofVanderhoof

WellsWells QuesnelQuesnel

WilliamsWilliams Lake

3 Vancouver 100100 MileMile HouseHouse GoldenGolden Coastal RevelstokeRevelstoke SecheltSechelt 1 InteriorInterior InvermereInvermere 3 Vancouver Coastal LillooetLillooet SalmonSalmon ArmArm NorthNorth Vancouver PortPort McNeillMcNeill KamloopsKamloops VANCOUVERVANCOUVER BurnabyBurnaby 2 Fraser 4 VancouverV CampbellCampbe lIslandl MMerritterritt RichmondRichmond SurreySurrey an RiverRiver KelownaKelowna CCranbrookranbrook LangleyLangley co NelsonNelson u ComoxComox 3 Vancouver PPentictonenticton ve 2 FraserFraserHopeHope CrestonCreston WhiteWhite Rock r Island ParksvillePCoastalarksville LadysmithLadysmith NanaimoNanaimoSEE OsoyoosOsoyoos TofinoTofino SOUTHWEST BC INSET Duncan U.S.A. SSidneyidney 4 Vancouver Island

VICTORIAVICTORIA 1:2,000,000 SookeSooke 0 5 10 20 30 40 1:8,500,000 0 40 80 160 240 320 400 480 Kilometers km

Ministry of Health, 2019 12

British Columbia Health Service Delivery Areas

NORTHWEST TERRITORIES HSDAs: 11 East Kootenay 12 Kootenay Boundary 13 Okanagan 14 Thompson Cariboo Shuswap 21 Fraser East 22 Fraser North YUKON 23 Fraser South 31 Richmond 32 Vancouver 33 North Shore/Coast Garibaldi FortFort NelsonNelson 41 South Vancouver Island 42 Central Vancouver Island 43 North Vancouver Island 51 Northwest 53 52 Northern Interior 51 53 Northeast 1. Nisga'a is a separate governance health board FortFort St. John StewartStewart DawsonDawson Creek

1 MackenzieMackenzie NewNew HazeltonHazelton TumblerTumbler RidgeRidge ALBERTA Nisga’a SmithersSmithers TTerraceerrace HoustonHouston FortFort St.St. JamesJames PrincePrince Rupert 52 KitimatKitimat PrincePrince George VanderhoofVanderhoof

WellsWells QuesnelQuesnel

33 WilliamsWilliams Lake 100100 MileMile HouseHouse GoldenGolden 14 RevelstokeRevelstoke SecheltSechelt 33 SalmonSalmon ArmArm InvermereInvermere NorthNorth Vancouver22 LillooetLillooet PortPort McNeillMcNeill KamloopsKamloops 11 VANCOUVERVANCOUVER BurnabyBurnaby 43 32 MapleMaple RiRiddgege MMerritterritt RichmondRichmond SurreySurrey 21 CampbellCampbell RiverRiver 33 KelownaKelowna 12 CranbrookCranbrook 31 LangleyLangley NelsonNelson 23 CComoxomox 13 PPentictonenticton 21 HopeHope CrestonCreston WhiteWhite Rock ParksvilleParksville 22 LadysmithLadysmith SEE OsoyoosOsoyoos TofinoTofino NanaimoNanaimo SOUTHWEST23 42 BC INSET 42 Duncan 41 U.S.A. SSidneyidney

41 VICTORIAVICTORIA 1:2,000,000 SookeSooke 0 5 10 20 30 40 1:8,500,000 0 40 80 160 240 320 400 480 Kilometers km

Ministry of Health, 2019 13

British Columbia Local Health Areas

YUKON NW TERRITORIES South Vancouver Island Sechelt 333 Gibsons332 Parksville 533 Fort Nelson 425 Nanaimo 516 424 Ladysmith 519 423

532 414 422 Duncan 511 Fort St. John 421 Sidney Dawson Creek 413 531 New Hazelton Mackenzie 518 513 412 523 411 517 Smithers 524 Victoria Terrace Fort St. James Sooke Prince Rupert Houston 1:1,600,000 512 514 05 10 20 30 40 Kitimat km Vanderhoof Prince George 522 510 ALBERTA 515 Quesnel 521

336 Williams Lake 145 146 100 Mile House 116 141 144 Golden 337 Revelstoke 143 142 Invermere Lillooet Kamloops 434 147 139 114 Port McNeill 148 135 121 124 Merritt 136 432 334 335 113 Campbell River 149 137Kelowna Cranbrook Powell River See 122 111 433 333 223 215 138 Nelson 112 Comox Lower 132 123 Greater Vancouver 431 Mainland 211 134 127126 115 Creston See VancouverInset Hope 133 131 125 332 331 426 North Vancouver Tofino South 212 Osoyoos Vancouver Port Moody Island Lower Mainland 224 422 321 322 412Inset 211 Burnaby Coquitlam Victoria Vancouver 323 335 324 325 222 215 326 New Westminster Squamish 221 U.S.A. 333 Surrey 223 Richmond Sechelt 214 311 233 332 331 224 Delta See Maple Ridge Greater Mission Langley 232 Vancouver233 231 212 Inset 213 1:2,500,000 234 010 20 40 60 80 km 234 1:500,000 White Rock 01.5 3 6 9 12 1:8,000,000 km 040 80 160 240 320 400 480 km Nisga’a is a separate governance health board.

Ministry of Health, 2019 14

British Columbia Local Health Areas

1 Interior 2 Fraser 4 Vancouver Island 11 East Kootenay 21 Fraser East 41 South Vancouver Island 111 Fernie 211 Hope 411 Greater Victoria 112 Cranbrook 212 Chilliwack 412 Western Communities 113 Kimberley 213 Abbotsford 413 Saanich Peninsula 114 Windermere 214 Mission 414 Southern Gulf Islands 115 Creston 215 Agassiz/Harrison 42 Central Vancouver Island 116 Golden 22 Fraser North 421 Cowichan Valley South 12 Kootenay Boundary 221 New Westminster 422 Cowichan Valley West 121 Kootenay Lake 222 Burnaby 423 Cowichan Valley North 122 Nelson 223 Maple Ridge/Pitt Meadows 424 Greater Nanaimo 123 Castlegar 224 Tri-Cities 425 Oceanside 124 Arrow Lakes 23 Fraser South 426 Alberni/Clayoquot 125 Trail 43 North Vancouver Island 126 Grand Forks 231 Langley 127 Kettle Valley 232 Delta 431 Comox Valley 233 Surrey 432 Greater Campbell River 13 Okanagan 234 South Surrey/White Rock 433 Vancouver Island West 131 Southern Okanagan 434 132 Penticton 3 Vancouver Coastal 133 Keremeos 5 Northern 134 Princeton 31 Richmond 135 Armstrong/Spallumcheen 311 Richmond 51 Northwest 136 Vernon 32 Vancouver 510 Haida Gwaii 137 Central Okanagan 511 Snow Country 321 Vancouver – City Centre 512 Prince Rupert 138 Summerland 322 Vancouver – Centre North 139 Enderby 513 Upper Skeena 323 Vancouver – Northeast 514 Smithers 14 Thompson Cariboo Shuswap 324 Vancouver – Westside 515 Kitimat 141 Revelstoke 325 Vancouver – Midtown 516 Stikine 142 Salmon Arm 326 Vancouver – South 517 Terrace 143 Kamloops 33 North Shore/Coast Garibaldi 518 Nisga’a* 144 100 Mile House 331 North Vancouver 519 Telegraph Creek 145 North Thompson 332 West Vancouver/Bowen Island 52 Northern Interior 146 Cariboo/Chilcotin 333 Sunshine Coast 147 Lillooet 521 Quesnel 334 Powell River 522 Burns Lake 148 South Cariboo 335 Howe Sound 149 Merritt 523 Nechako 336 Bella Coola Valley 524 Prince George 337 Central Coast 53 Northeast 531 532 Peace River North 533 Fort Nelson

* Nisga’a is a separate governance health board.

Ministry of Health, 2019