New physician agreement

Overview

A new agreement between government and the Alberta Medical Association has been ratified by physicians throughout the province.

Overview

An agreement has been reached between the Government of Alberta and the Alberta Medical Association (AMA).  

Many months of effective interest-based negotiations between Alberta Health and the AMA resulted in productive discussions that focused on our many common interests, and led to an agreement that supports shared priorities.  

This agreement with its significant investments will provide a path forward to address the challenges the health system is currently facing. It contains concrete solutions, with financial resources behind them, to address these challenges. The agreement will stabilize the health system, target areas of concern and most importantly, will support Albertans’ health care needs.

The agreement will be in force for 4 fiscal years, from April 1, 2022 to March 31, 2026.

Highlights

  • Repealing Section 40.2 of the Alberta Health Care Insurance Act

    • Bill 4, the Alberta Health Care Insurance Amendment Act, 2022, was introduced on December 5, 2022, to follow through on a commitment made as part of the new physician agreement.
    • If passed, the act will repeal Section 40.2 of the Alberta Health Care Insurance Act which allows the government to terminate compensation-related agreements with the AMA.
    • Moving quickly to introduce Bill 4 is an important step towards rebuilding the relationship with physicians and will help ensure Albertans receive the health care support they need when and where they need it.
    • If passed, the Alberta Health Care Insurance Amendment Act, 2022, will take effect on Royal Assent.
  • Compensation

    • 1% rate increase in each of the first 3 years (2022-23 to 2024-25).
      • Government is working with the AMA to implement a 1% rate increase for 2022-23. The increase applies to fee-for-service and alternative relationship plan rates, providing an additional $46 million to physicians.
      • The rate increase is heavily weighted to specialties facing the greatest pressures, such as family medicine.
      • Increases will be effective April 1, 2022 and are expected to be finalized by March 31, 2023.
    • 1% recognition lump sum payment in 2022-23.
      • Alberta physicians were at the forefront of the pandemic and the one-time payment for eligible practising physicians is in recognition of that work during the 2021-22 fiscal year.
      • The lump sum payment is approximately $45 million and will go to the AMA to distribute to their members by the end of 2022.
    • The first 3 years of the agreement provide rate stability, with no market corrections for above or below market rates. Year 4 (2025-26) will involve:
      • implementation of results from a comprehensive market rate review based on comparisons with Ontario-west jurisdictions
      • a global rate adjustment to reflect general economic and fiscal conditions 
      • potential binding arbitration for both the market rate review and global rate adjustment
      • gainsharing in years 3 and 4 where the AMA can receive 50% of any savings achieved by keeping cost growth below population and complexity 
  • Targeted investments

    • A total of $252 million over 4 years through $59 million in annual funding during the term of the agreement and $16 million in one-time investments to support practice viability and recruitment and retention of family physicians and specialists in communities facing issues:
      • $15 million annually for physician recruitment and retention
      • $12 million annually for the Rural Remote Northern Program
      • $12 million annually for physician support programs
      • $2 million one-time investment for RESIDE  
      • $20 million annually for the Business Costs Program
      • $14 million one-time investment for change management and information technology 
  • Recruitment and retention

    • Up to $15 million annually to support recruitment and retention for physicians who practice full-time in underserved areas.
    • Up to $12 million annually to increase funding for the existing Rural Remote Northern Program, which provides financial incentives to physicians who live and practice in underserviced communities.
    • $12 million annually to enhance certain physician support programs, including the medical liability reimbursement program, continuing medical education program, and physician locum programs.
    • A one-time investment of $2 million to increase funding for the existing RESIDE program that provides incentives for family physicians to practice in Alberta’s underserved rural and remote communities.
  • Practice viability

    • Increases to the Business Costs Program’s rate, which is estimated to increase Business Costs Program spending by around $20 million each year during the term of the proposed agreement. This program provides a premium to support physicians’ business costs, with greater impact on family physicians and specialists in office-based practices.
    • Up to $2 million in one-time funding to assess change management supports for physicians considering alternate payment models.
    • A one-time investment of up to $12 million over 2 years to support physicians in adopting new, integrated information technology systems that improve patient care across the province.
  • Primary health care

    • Lump sum increases for Primary Care Networks of $20 million in each of 2022-23 and 2023-24 to provide additional support for primary care while the Modernizing Alberta’s Primary Health Care System work takes place. This is in addition to the $252 million in targeted investments.
  • Working collaboratively

    • Physicians will have shared responsibility to review compensation rates, relative to market, and help bring them into closer alignment with peer provinces. Engagement will continue with the AMA during the review process, as well as during the global rate adjustment, through joint committees.   
    • The agreement also outlines processes and other commitments to jointly address key issues related to physician compensation, including: 
      • stipends, overhead and z-codes
      • caps to daily visits 
        • The daily visit services cap policy was lifted as of December 1, 2022, to help increase patient access to physicians. 
        • By lifting the cap, physicians will be fully compensated for every visit service they provide, rather than receiving a discounted rate if they provide more than 50 visit services in one day.
      • virtual code enhancements for psychiatry 
      • extending physician support programs to medical examiners