Enrolling Patients to the Home Clinic
Manitoba’s Home Clinic model is substantially different from Ontario’s. Key differences include:
- The Home Clinic model enables choice for primary care clinics and the clinicians practicing there. Clinics are not required to register as a Home Clinic, and no provider is required to be associated with a Home Clinic.
- The Home Clinic model enables choice for patients. No patient is required to enrol with a Home Clinic but if they do so, they will not be prevented from seeking care elsewhere. Similarly, providers will not be adversely impacted should their patients receive care from an episodic provider.
- Home Clinics is not funded on a per capita basis. In fee-for-service Home Clinics, Physician MRP are compensated by providing continuous and comprehensive care to their enrolled patients, and subsequently claiming Comprehensive Care Management tariffs. Regional Health Authorities receive funding for provider salaries and operational expenses.
- The Home Clinic model strives to improve continuity of care for Manitobans, and lays the foundation for improved continuity of information to benefit patients and their providers. Refer to Future Direction: Episodic Information Sharing for more information.
Who is eligible to enrol with a Home Clinic?
All residents of Manitoba and residents of Canada (excluding Quebec, which does not have a reciprocal billing agreement with Manitoba) are eligible to enrol with a registered Home Clinic. As a Home Clinic, you will provide comprehensive, continuous and coordinated care for your enrolled patients. Therefore, you should not enrol episodic patients or visitors to Manitoba.
How are patients enrolled?
Patients may be enrolled using one of two methods: Active or Passive enrolment.
Active patient enrolment directly involves the patient in the enrolment decision. The process involves direct communication with the patient and ensures their understanding of the benefits of Home Clinic enrolment. The communication also clarifies the responsibilities of both parties: the Home Clinic and the enrolled patient. When an active enrolment occurs, and there is an enrolment agreement, the date of the active enrolment is documented in the EMR as the Enrolment Start Date. An active enrolment communication can occur with new or existing patients, and also with patients who were initially passively enrolled.
Passive enrolment does not involve communication with the patient. Candidates for passive enrolment are identified by the Home Clinic through analysis of data within their Electronic Medical Record (EMR) system. Review our tips for this analysis before you get started.
Click for information on submitting your enrolment data.
Can a patient enrol with more than one Home Clinic?
Patients may only be enrolled with one Home Clinic at a time. A primary objective of a Home Clinic is to improve the continuity of care and information for a patient. In order to achieve this objective, enrolment must be limited to a single Home Clinic at any one time.
Can a patient decline to enrol with a Home Clinic?
Yes. Enrolment is not mandatory in Manitoba, and patients may choose not to enrol. If so, a fee-for-service family physician would not be able to claim the CCM tariff from that patient. It is our hope that once patients understand the benefits of belonging to Home Clinic, most patients will agree to enrol.
Can the Home Clinic decline to enrol a patient?
A Home Clinic can decline to enrol a patient, but must follow the College of Physicians and Surgeons of Manitoba’s Bylaw 11, Practice Management, section B, Prohibited Grounds for Refusing Patients in the decision-making process. For example, a member must not refuse to accept a person as a patient because the medical care required could or will be complex, unless the care the patient requires is beyond the clinical competence of the Home Clinic team or the Most Responsible Provider.
Nurse practitioners are employed by organizations such as regional health authorities. As such, they will adhere to the organization’s relevant policies.
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