Overview

To protect our universally accessible, publicly funded health care system, we need to take meaningful action to improve key components of our system.

A new physician compensation agreement with the Alberta Medical Association (AMA) is needed.

As part of the consultations, the Government of Alberta has made 11 proposals to the AMA to help build a stronger and more sustainable health system while managing physician spending growth.

Proposal 1: Complex modifiers

Complex Modifiers were intended to incent doctors to spend more time with patients with complex medical needs. But instead of reserving the modifier for complex patients, some doctors use it for all patients.

Currently, doctors can bill for extra time when a patient visit exceeds a base amount of time. For family physicians the base time is set at 14 minutes.

Our new Physician Funding Framework:

  • extends the amount of time physicians spend with patients by 10 minutes before additionally time can be billed
  • allows this additional payment on top of their normal base fee at the 24 minute mark
  • keeps Alberta the only province in Canada to offer this time-based incentive
  • phases the change in over 2 years for general practitioners
  • saves $197 million annually by 2022-23

Analysis shows that use of these modifiers has grown consistently to the point where these modifiers are being used on approximately half of all eligible visits. In 2018-19:

  • 100 doctors in Alberta charged complex modifiers on 100% of their claims. This was not the intention; modifiers were designed to be used for patients who are complex only.
  • 54% of general practioner visits claimed a complex modifier versus 40% in 2013-14. This is an increase of 35%.

Doctors are well trained to deal with medical conditions, and half of all medical visits should not be billed as complex.

More information