For years, the conversation about Ontario’s primary care system has been about what is broken. Not enough family doctors. Too many unattached patients. Too much administrative burden. Too little pay. That conversation has shifted. Through the 2026 Ontario Budget, the province committed $3.4 billion over four years to fundamentally restructure how primary care is organized, funded, and delivered across Ontario. For physician practices, this is not just a policy story. It is a strategic planning signal that will shape the next five years of your career.
Context
Ontario’s Primary Care Action Plan was launched in January 2025, with a mandate led by Dr. Jane Philpott and the Primary Care Action Team (PCAT) to connect every Ontarian to a family doctor or primary care provider by 2029. The 2026 Budget added $325 million to that plan, bringing total four-year investment to $3.4 billion.
The results so far have been faster than expected. As of January 2026, Ontario had already attached 330,000 people to primary care in 2025-26, exceeding its target of 300,000 by more than 10%. The Health Care Connect waitlist — which stood at roughly 235,000 people as of January 1, 2025 — has been cut by more than 87%. The government has committed to clearing the remaining waitlist by Spring 2026.
124 new and expanded primary care teams have been selected to launch in 2026-27, with a mandate to connect 500,000 more people to ongoing care. That is half a million new patients entering the primary care system in the next 12 to 18 months.
What This Means for Your Practice
The Patient Volume Story Is Changing
For the last decade, unattached patients have been one of the most visible symbols of Ontario’s primary care crisis. The same structural shortage that left 1.9 million Ontarians without a regular family doctor also meant that physicians who wanted to grow their rosters often could not find the support to do so safely.
That is changing. The Primary Care Action Plan’s team-based model is designed to support physicians in taking on more patients by surrounding them with nurse practitioners, registered nurses, pharmacists, social workers, and other allied health professionals — all under one roof. For practices that are structured for growth, the infrastructure is arriving to support it.
In Windsor-Essex specifically, the shortage has been acute. Estimates have put the number of unattached local residents at 40,000 or more. ONRx, a virtual care partnership, launched specifically to serve Windsor-Essex unattached patients as part of Ontario’s broader strategy. Physicians in this region who are positioned to absorb new patients — or to partner with new team-based models — are entering an environment that is actively channeling people toward them.
The EMR Story Will Affect Every Practice
The single most disruptive piece of the Budget 2026 primary care plan is not the funding. It is the announcement of a provincewide Primary Care Medical Record system.
Approximately 90% of Ontario family physicians already use an electronic medical record system. But those systems are fragmented. Each clinic maintains its own separate instance. When a patient moves from one practice to another, or when a specialist needs to access primary care records, the information does not follow them. The result: repeated health histories, unnecessary duplicate tests, and care gaps that cost time and money on both sides.
The government is now procuring a single, interoperable provincewide EMR that family physicians can choose to migrate to. The government has signaled it will support transition costs for physicians who opt in. A Market Sounding with EMR vendors is already underway via the Ontario Tenders Portal.
What this means for your practice, practically:
First, nothing is mandatory yet. The migration is opt-in and the rollout timeline has not been finalized. You do not need to make a decision today.
Second, this is a planning horizon issue. If you are approaching a natural EMR contract renewal in the next one to two years, it is worth watching the procurement process before committing to another multi-year term with your current vendor.
Third, practices that are already well-organized digitally — clean patient records, good data hygiene, consistent coding — will have a much smoother migration experience when this system arrives. Practices that have years of messy data will face a harder transition.
Fourth, there are administrative burden implications. The government has explicitly stated that the new system will reduce paperwork, streamline referrals, and allow physicians to spend more time on patient care. If that promise is delivered, it changes the calculus on staffing and billing workflow.
What 500,000 New Attached Patients Means for Practice Capacity
The 500,000 people who will be attached to primary care through the 2026-27 call for proposals are not evenly distributed. They are clustered around the 124 new or expanded teams that were selected. Some of those teams will be in Windsor-Essex. Some will be in communities where your referral base and specialist relationships already exist.
The pressure this creates is not just clinical. It is operational. More attached patients mean more billing complexity, more care coordination, more staff. For practices that are not set up to scale, this wave of new patients becomes a burden instead of an opportunity.
The physicians who will benefit most from the next three years of this plan are those who are organized, billing correctly, and have the operational infrastructure to grow without burning out their teams. That is not a coincidence. The government has structured this plan to reward practices that are ready.
The FHO+ Connection
The 2024 PSA and FHO+ are not separate from the Budget 2026 primary care plan. They are the same project. FHO+ is the compensation framework designed to make the family medicine model financially attractive enough to retain existing physicians and attract new ones. The Primary Care Action Plan is the infrastructure investment designed to give those physicians the team support, digital tools, and patient volume to make the model work at scale.
For FHO physicians specifically: the next 18 months are likely to be the most consequential operating environment you have experienced. New compensation codes went live April 1. New patients are being funneled into your region. New digital infrastructure is being built. Practices that understand all three layers of this change — and are managing their billing, operations, and growth strategy accordingly — will be positioned very differently from those that are just reacting to each change as it arrives.
What You Should Do
- Review your current patient attachment capacity. If you have roster space and the operational infrastructure to take on new patients, this is the time to signal that to the appropriate bodies (Health Care Connect, your regional Ontario Health Team).
- Monitor the provincewide EMR procurement. If you are approaching an EMR contract renewal, wait for more clarity on the government’s timeline and cost-support structure before committing.
- Audit your current EMR data quality. Clean, well-coded patient records make every transition easier — including the one coming from the new system.
- Think through your team structure. If 2026-27 brings a significant influx of new patients into your region, do you have the staffing and workflow to absorb them without creating a billing or care quality problem?
- Connect with your regional Ontario Health Team to understand what primary care team expansions are planned in your area.