Data source: BC Ministry of Health
April 1, 1985 onward
Note: the MoH's Access to Health Data for Research policy may be found here
Data on medically necessary services provided by fee-for-service practitioners to individuals covered by the Medical Services Plan (MSP), BC's universal insurance program. Practitioners are separated into: physicians, supplementary benefit practitioners (physiotherapists, massage practitioners, naturopathic physicians, etc.), and out-of-province practitioners..
- Fields available
Both Core and Non-Core fields are available for this data set.
Core vs. Non-Core Data
Core Data: Some data available through PopData and the HDP are ‘Core Data’. Core Data are data identified by the data provider as 'Safe Data' and eligible for pre-approved release, with the exception of PharmaNet data. Core Data includes commonly-requested data columns, but not necessarily all of the columns available in a data set. For example, some Core Data fields, such as geography or organisational codes, have been suppressed for increased privacy.
Please note that the overall data access request is subject to meeting ALL of the Five SAFEs requirements, not just the Safe Data component. For more detail on the Five SAFEs, visit the HDP website.
Non-Core Data: Non-Core Data are data NOT identified by the data provider as 'Safe Data' and thus are NOT eligible for pre-approved release. Access to Non-Core Data follows the usual processes and will not follow expedited review procedures.
For the majority of DARs, requesting access to Core Data may make the data access approval process quicker and reduce the wait time for data access. It may also reduce the need for time-consuming data amendments related to a request for additional data fields or changes to study populations.
- All medically required services provided by fee-for-service practitioners, including laboratory and diagnostic procedures (x-rays, ultrasounds etc.), and dental and oral surgery performed in hospital.
- Some additional billing information, e.g. no charge referrals, nurse practitioners, Primary Health Care encounters claims, and other encounter claims appear in the data as "shadow billings".
- Payments made on behalf of BC residents who obtained services in Quebec, the U.S. and other countries are included. These payments appear in the MSP data because they have gone through the regular adjudication process. Please see the note under ‘exclusions' regarding services obtained in other provinces and territories in Canada.
- Data on abortion procedures, including those conducted in concert with other procedures, are only available by special request. Requests must demonstrate how Therapeutic Abortion (TA) data is required to fulfill the research objectives by providing a strong rationale. The Ministry of Health will review requests and make a decision on release according to existing policy on a case-by-case basis. This is in accordance with the BC Freedom of Information and Protection of Privacy Act article 22.1.
- Services provided through alternative payment plans, such as salaried, sessional, and service agreement contracts, etc. do not appear in the MSP payment files.
- In April 2002, MSP stopped covering the majority of supplemental benefit services. These include: chiropractic, massage therapy, physical therapy, naturopathy, optometry, and podiatry services. These services are still provided in medically necessary cases for lower income individuals.
- All provinces and territories (except Quebec) participate in ‘reciprocal billing agreements', where Canadians with coverage from other provinces or territories who receive services out-of-province are provided services without charge, and the providing province bills the services back to the home province. Records of these services are kept in a separate file (the "out of province services" file) and the amount of information collected is far less than what is included in the MSP Payment file. There are sometimes significant implications for understanding service use in areas bordering Alberta in particular, where it may make more sense for patients to receive care from a provider in Alberta rather than one in BC.
- Population Data BC does not receive some payment adjustment fields in our data files. For most projects, this exclusion will have little meaningful impact.
- All records that are associated with an ICBC or WorkSafeBC claim type are excluded from our standard MSP Collection (roughly 3.5 percent of MSP records; or 1.6 and 1.9 percent for WSBC and ICBC respectively). If the WorkSafeBC records in the MSP file are essential for your research, additional approval may be obtained from WorkSafeBC by selecting the option in the MSP data checklist when submitting the Data Access Request (DAR) to Population Data BC. Unfortunately, this option is not currently available for ICBC records.
- Payments to physicians who perform WorkSafeBC expedited surgeries in public hospitals do not appear in the MSP Payment files. Expedited surgeries are paid at a different rate than what is specified in the MSP fee schedule and so are billed directly to WorkSafeBC.
- Quality/accuracy of information/field coding source
- The majority of billing records are submitted electronically by practitioners' offices to MSP. MSP conducts audits/quality checks for select fields.
- There are ICD (diagnosis) codes in this file. These are still collected in ICD-9 format. Up to five ICD-9 codes are included per record, and these are generally considered accurate only to the 3rd digit level. These codes have been shown to be valid at the population level (Hu 1996). > download MSP Diagnostic Codes on MSP Claim Data (635 kb pdf)
- Important additional information
- This file is originally organized as a payment date file, i.e. a record for each payment made during a fiscal year. Population Data BC reorganizes the file to provide researchers with the MSP payment data organized by the date services are provided. This is a more relevant organization for research purposes, but researchers should be aware that the most current year of MSP payment data available is approximately 5-10% incomplete. There can be up to a six month lag between when a service is provided and when payment for that service is made and a record entered into the MSP payment data. Some records for services provided in particular in the last quarter of the most current year may not show up in the payment data until the first quarter of the following fiscal year. For example, a record for a service provided on February 15, 2001 may not show up in the MSP payment data prior to March 31, 2001, which is the close of the data year. If the most current year of payment data available is 2000/01, the payment record for that service will not be included in the Population Data BC data holdings until the 2001/02 MSP payment data are available. >> more details
- Similar to the situation described above, there are instances when retroactive payments are provided en masse to physicians, e.g. because of fee increases that are applied back in time. In this case, there may be many millions of records for services in one year that show up in a subsequent fiscal year of data. In this case, it is not services that are missing. The service date and provider are complete, but the total amount paid may be incomplete until the fiscal year payment data "catch up" to the fiscal year service data.
- Claims for specific services can sometimes be split into more than one payment record. One example is retro-payments discussed above. In addition, multiple services may need to be combined to represent a single encounter. In most cases, we consider an ‘encounter' the unique combination of physician, patient and date of service.
- The number of services paid by non fee-for-service methods, i.e. alternative payment plans, such as salaried, sessional, and service agreement contracts, has been increasing dramatically in recent years (CIHI 2008). The relative importance of these alternative payments varies by region (greater alternative payments schemes in rural and remote areas of the province) and by specialty of physician.
- Hu W. Diagnostic Codes in MSP Claim Data, Summary Report. Victoria: Medical Services Plan; 1996.
- Canadian Institute for Health Information (CIHI). Physicians in Canada: The Status of Alternative Payment Programs, 2005-2006. Ottawa: CIHI; 2008. Available at: http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=GR_27_E&cw_topic=27