Clinical Alternative Relationship Plans (ARP)

Clinical ARP models

There are 3 service delivery models to compensate physicians for providing clinical services to a target population:

Annualized model

• Annualized Clinical ARP compensation is based on the full-time equivalents (FTE) required for physicians to deliver clinical services for all specialties.
• A FTE is a time-based unit of measure, for example, hours per year.
• The annualized model provides funding to physicians, based on a pre-determined payment rate and FTE per year, for the delivery of specific program services to targeted patient groups.

Sessional model

• Sessional Clinical ARP compensation is based on an hourly rate for the delivery of clinical services.
• The sessional model primarily applies to small, specialized programs and services, and is intended for part-time physicians working up to an equivalent of 2 days per week on average over one fiscal year.

Email us at [email protected] for inquiries regarding:

• Annualized Clinical ARP rates and associated FTE definitions for specific physician specialties
• Sessional Clinical ARP hourly rates

Blended Capitation model

Blended Capitation Model (BCM) Clinical ARP compensation is based on an annual payment amount per rostered patient, plus a component of fee-for-service payment.

• BCM payment rates are determined by patient age, sex, and complexity.
• Learn about the Blended Capitation Clinical ARP model.

Clinical ARP Framework

The Clinical ARP framework supports transparency, equity, and consistency across all Clinical ARPs.

A Clinical ARP is governed by:

• the overarching program parameters, which set out the general rules for all Clinical ARPs
• the conditions of payment for the specific Clinical ARP

The program parameters and conditions of payment make up the Clinical ARP framework. The Clinical ARP Framework Explained companion document explains the concepts of Clinical ARPs in plain language.

• Read the Clinical ARP Program Parameters
• Read the Clinical ARP Framework Explained document

Establish a Clinical ARP

Establishing a Clinical ARP includes:

• developing an Expression of Interest
• developing an application
• developing the conditions of payment
• signing of a Ministerial Order
• implementing the Clinical ARP

To establish a Clinical ARP, a physician group may work with Alberta Health, and Alberta Health Services (AHS) to explore whether a Clinical ARP is an appropriate way to support physicians in the delivery of a service or program. The Alberta Medical Association (AMA) may also be included in this process at a physician’s request.

Initial development

The development of a Clinical ARP begins when a physician group identifies health services that could benefit from a Clinical ARP, such as a service gap or existing services that struggle under the existing fee-for-service compensation structure.

Physicians then work with Alberta Health to explore whether a Clinical ARP is a good fit to meet service delivery requirements.

If the physician group determines they want to pursue a Clinical ARP, they can develop an expression of interest to submit to Alberta Health for review and consideration.

While AHS may be involved in the initial exploration of an ARP, the main interaction will occur with Alberta Health. The physician group may work with the AMA during this stage as well.

Expression of interest

An expression of interest is a short document that informs Alberta Health and AHS that a physician group is interested in pursuing a Clinical ARP application, or expanding their current Clinical ARP.

The expression of interest includes basic information about the proposed Clinical ARP, including intended location, patients to be served, and program services to be provided.

• The expression of interest is not meant to be an exhaustive review of the proposed program and should be clear and concise.
• Download the Expression of Interest document.

During this stage, it is important to declare who the Authorized Representative (AR) will be for the program. An AR is a participating physician who has been authorized by the other participating physicians of the Clinical ARP to act as their agent with respect to the Clinical ARP and is responsible for liaising with Alberta Health. There must always be at least one AR attached to a Clinical ARP (preferably with an alternate).

Application

Once the expression of interest has been accepted, the physician group must draft a Clinical ARP application. The physician group may also elect to work with the Alberta Medical Association, or other consultants of their choosing, for assistance in drafting the application. For programs that will be delivered within AHS facilities, the physician group must work with AHS to draft the application.

The application includes detailed information about the goals, program services, patients, service delivery model, practice management, governance, and non-physician professional support of the Clinical ARP.

• Download the Clinical ARP application template
• Read the Clinical ARP application guidelines

Conditions of payment

Once the Clinical ARP application has been accepted by Alberta Health, the Clinical ARP’s Conditions of Payment (CoP) is drafted using the information provided within the Clinical ARP application.

Once finalized, the CoP is then sent for the Deputy Minister’s approval under a Ministerial Order.

Clinical ARP set up

Once a Clinical ARP has been approved for establishment, the authorized representative is required to register and operationalize the Clinical ARP.

Complete and submit forms:

• ARP 006
  • application to register an approved Clinical ARP
  • read the instructions for completing Form ARP 006

Clinical ARP operations

Service event reports

Service event reports are submitted via H-Link, similar to fee-for-service reports. Participating physicians use their ARP Business Arrangement (BA) when submitting and can use codes from either the SOMB or the ARP Service Code Schedule. All Clinical ARP physicians must submit service event reports for the program services they deliver as a condition for being paid under a Clinical ARP.

Sessional invoicing

Sessional Clinical ARPs submit claims for benefits using the service event reporting tool. To ensure accurate compensation, a time modifier must be added to the health service code to record the amount of time spent on that service in 5-minute allotments.

Program service definitions (annualized models)

In order to calculate monthly full-time equivalents (FTEs), annualized models follow the Clinical ARP’s FTE definition. The FTEs for Clinical ARPs are defined in either program service hours or program service days. This is important as annualized programs are required to report their FTEs monthly.

Reconciliation (annualized models)

Alberta Health reconciles payments made to Annualized ARPs by comparing the terms of each Annualized Clinical ARP’s Conditions of Payment with the actual FTEs reported by each Clinical ARP. Payment adjustments for any over-or under-payments may be made once per fiscal year.

Changing Authorized Representatives

To change, remove or add an authorized representative for a Clinical ARP, contact Alberta Health.

Clinical ARP forms

Individual physicians participating in Clinical ARPs should use the forms below to join or terminate participation in a Clinical ARP.

Physicians not registered with Alberta Health must apply to the practitioner registry and acquire a practitioner ID before registering with a Clinical ARP. Email [email protected] for assistance with requesting a Practitioner ID.

• ARP 007 – ARP Business Arrangement Request
  • change business arrangement (BA) information
  • update existing Clinical ARP, add a new BA, or set up a non-payment BA
• ARP 008 – Letter of Participation (LOP) – add a participating physician
• ARP 010 – Letter of Termination (LOT) – terminate a participating physician
• ARP 009 – Locum Physician Registration Letter – add a locum physician
  • locum physician should not submit an LOP
• ARP 011 – Locum Physician Termination Letter – terminate a locum physician
  • locum physician should not submit an LOT

Publications

• ARP bulletins

Contact

Connect with the Alternative Compensation Delivery Unit:

Hours: 8:15 am to 4:30 pm (open Monday to Friday, closed statutory holidays)
Phone: 780-643-1436
Toll free: 310-0000 before the phone number (in Alberta)
Fax: 780-422-5208
Email: [email protected]

Address:
Alberta Health
Alternative Compensation Delivery Unit
Provider Compensation and Strategic Partnerships Branch
PO Box 1360, Station Main
Edmonton, Alberta  T5J 2N3