Medical Services Plan of British Columbia

History

British Columbia introduced a provincial medical plan on 1 September 1965 during the premiership of W. A. C. Bennett. The program was subsequently aligned with the federal Medical Care Act as the province joined the national Medicare framework in 1968.

Administration

MSP is managed under the statutory authority of the Medical Services Commission (MSC), established by the Medicare Protection Act, which sets physician payment policy and administers the plan. Day-to-day beneficiary and claims administration are delivered through Health Insurance BC (HIBC). In 2022 the province awarded the HIBC services contract to Pacific Blue Cross’s affiliate PBC Solutions, with transition away from Maximus BC beginning that year. PBC Solutions would take on administration in spring 2023 and that operations would move to Central Saanich.

Benefits

For eligible residents, MSP pays for medically required services provided by enrolled physicians and surgeons. It also covers dental or oral surgery performed in hospital when medically necessary, maternity care by physicians or registered midwives, and insured diagnostic procedures ordered by enrolled practitioners. Some optometry services are insured when medically necessary, while routine exams for adults are generally not covered.

Funding and premiums

MSP premiums were cut by 50 percent on 1 January 2018 and fully eliminated on 1 January 2020. The province implemented an Employer Health Tax in 2019 as part of the funding transition. A planned premium increase announced earlier in 2016 was cancelled amid a pre-election fiscal update that redirected funds to housing affordability and other priorities.

Claims processing and Teleplan

MSP’s electronic claims are transmitted through Teleplan. Teleplan lets practitioners submit claims and notes, check eligibility, and retrieve remittance information over an encrypted internet connection. The province reports that Teleplan processes over 9 million claims monthly, valued at approximately $330 million, and that about 98.8% of claims are processed within 30 days, with a majority paid within 14 days. Earlier Teleplan manuals reported lower volumes at the time, such as about 7.6 million monthly claims valued at around $300 million. The plan operates using twice-monthly payment timing and cut-off dates.

The province reports that MSP collaborates with the Medical Software Vendors Association on Teleplan specifications and changes. Teleplan specifications date to 1988, with successive technical updates through the 1990s.

Administration and HIBC

Administrative operations for MSP and PharmaCare have been delivered under the Health Insurance BC (HIBC) banner since 1 April 2005, when Maximus BC assumed those functions under contract. The contract was extended in 2013, after which service delivery continued under HIBC. Accountability and privacy concerns have been raised related to outsourcing administration to Maximus following data breaches and lack of notable improvement.

Policy and premium changes

On 16 September 2016, Finance Minister Michael de Jong announced the cancellation of a planned four percent increase to MSP premiums and the reallocation of funds toward housing affordability and other priorities, drawing extensive coverage and debate.

Physician payment model and primary care attachment

From 2023 the province introduced the Longitudinal Family Physician (LFP) Payment Model to complement fee-for-service for community family practice. Independent reporting at launch and in early 2023 described a potential gross income near $385,000 for a full-time physician in the model, up from an estimated $250,000 under the old approach, with actual earnings depending on panel size, hours and complexity. A province-wide Health Connect Registry was expanded in 2023 to match residents with primary care providers, with independent outlets reporting rising match numbers through 2024.

References

References

1. (January 18, 2025). "New health minister has long to-do list, from improving cancer treatment to expanding involuntary care". Times Colonist.
2. (November 19, 2024). "David Eby makes significant changes to B.C. cabinet following election". Global News.
3. "Medicare Protection Act, RSBC 1996, c 286".
4. "How publicly funded health care coverage works".
5. (November 17, 2022). "An overview of physician payments and cost per service".
6. Fritz, Brad. (September 2015). "The origins of publicly funded medical care in BC and the BCMA’s contributions". British Columbia Medical Journal.
7. (2017). "The BCMA, Then and Now: A Selected History from 1965 to Doctors of BC". Doctors of BC.
8. (2023). "Medical Services Commission Annual Report 2022/23". Medical Services Commission.
9. Duffy, Andrew A.. (March 24, 2023). "In blow to downtown, medical-plan contractor expected to move work to Central Saanich". Times Colonist.
10. "Charging for uninsured services".
11. "Eye examination benefits and limits (overview for patients)".
12. (December 5, 2019). "British Columbians will no longer pay MSP premiums come 2020". CityNews Vancouver.
13. (December 5, 2019). "BC eliminates MSP premiums, employers to pay health tax". Castanet.
14. (September 16, 2016). "Bulging with New Cash, BC Liberals Eye Spending Spree into Election". The Tyee.
15. "Teleplan overview". Province of British Columbia.
16. (2015-03-29). "Claims Processing System". Province of British Columbia.
17. (2020). "Teleplan Introduction and Rules, v4.6". Province of British Columbia.
18. (2024-01-18). "MSP billing cut-off dates 2024".
19. "Billing MSP through Teleplan".
20. "Electronic Master Files, Teleplan v4.6". Province of British Columbia.
21. "Teleplan history of changes". Province of British Columbia.
22. "PharmaCare Annual Performance Report 2005". Province of British Columbia.
23. (2013-04-08). "B.C. renews contract with MAXIMUS BC". BC Gov News.
24. (2013-02-28). "Little benefit in outsourcing health administration". CityNews Vancouver.
25. (2014-01-16). "Taxpayers dinged nearly $1,000 a call after data breach". The Tyee.
26. (2005-07-29). "Health contractor Maximus fined in B.C.". The Tyee.
27. (2016-09-16). "Bulging with new cash, BC Liberals eye spending spree into election". The Tyee.
28. (2016-09-15). "MSP premium increase cancelled, assistance enhanced". BC Gov News.
29. (2022-10-31). "B.C. health: new pay model for doctors". CityNews Vancouver.
30. (2023-02-01). "B.C.’s new family doctor payment model takes aim at crisis in primary care". Times Colonist.
31. (2023-07-05). "Community limits lifted on B.C.’s registry for residents who need family doctors". Global News.
32. (2024-09-18). "Almost 250,000 patients matched with doctors through registry, province says". Times Colonist.