Activities

Year-end update

Negotiate an agreement for the provision of insured services with government that is fair to physicians and provides value for patients; and restores physicians, through the AMA as an active partner in the health system. 

• The Alberta Medical Association has attempted to work with the Minister of Health and the Government of Alberta since September 2019 to reach a negotiated agreement that would address the fiscal realities facing our province while protecting the health of Albertans. 
• On February 26, 2021, the AMA and the Government of Alberta reached a tentative agreement. With recommendation from the AMA Board of Directors and Representative Forum the Tentative Agreement Package was sent out to the broader membership for review and ratification on March 8, 2021. On March 30, 53% of those members who voted, chose not to ratify the agreement. As a result of the No vote, the following efforts were undertaken:
  • Gain an understanding of physician interests and concerns. This included feedback provided during the ratification process and summarized in the paper, “What We Heard”, input derived from working with members on issues of AHS Stipends, ARP rate setting and so on. Followed by the most recent paper sent to members, “Where We Are Going”, summarized the issues heard from members and puts them in the context of the most recent discussions with government and the changes needed in the TAP.
  • Deal with challenges and issues arising from the lack of an agreement, including:
• Status of AMA administered programs funded by government, including PFSP, ACTT, Rural Locum Program and Parental Leave.
• Supporting a wide range of activities aimed at adjusting physician compensation including AHS Stipend; AHS Overhead Review; laboratory and radiology negotiations, and the CARP rate review.
  • Explore with government any opportunities to achieve an agreement that can be supported by both AH and AMA.
  • Some progress was announced in the President’s Letter of July 2. It included:
• A series of initiatives including signing off on government funded programs until April 2022; an information sharing agreement so that AMA can again receive AH data; ad hoc committees to explore virtual care payment and continuing medical education support; a delay in the implementation of practitioner ID restrictions to allow for more consultation. These initiatives are completed or in the final stages of completion.
• A negotiation scoping exercise to determine whether a return to more formal discussions would have any chance of success. The scoping exercise was carried out at a staff level and explored physician and government interests, the implication of these interests for a revised TAP, and the challenges & opportunities presented by the AHS Stipend review, ARP rate review, Chartered Surgical Facility (RFPs) and so on. 
  • The staff-level scoping phase as mentioned above has been completed. 
  • In late July, the AMA Board of Directors appointed a negotiating committee to move forward with discussions with government. The committee has had numerous internal meetings with joint meeting dates selected for late-August.  
• Through the President’s letter, the AMA has endeavored to provide communication to the membership related to the status of negotiations and the lawsuit on a regular basis.

Represent interests of the AMHSP Council’s Negotiations Committee in the development of the new Academic Medicine Health Services Plan (AMHSP) Master Agreement and Individual Services Agreement template for AMA members who are part of the AMHSP, to take affect April 2021.

• AMHSP Council continues to provide a strong link between grassroots AMHSP physicians and the AMA. Their input into AMA consideration of issues and policy development shapes Council’s work.
• One new member was appointed to Council, and one member re-elected to Council in the spring as part of ongoing refreshment and renewal of membership.
• Council continues to pursue the 15 declared negotiating interests in various venues including provincial multi-stakeholder committees as it reviews policies being proposed at provincial tables.
• Relationship-building with other stakeholder groups, including Faculties of Medicine and Faculty Associations continues to be a focus.
• Engagement in policy development is an ongoing challenge; AH continues to present policy in near-fully developed format with very little opportunity for AMA contribution.
• Council developed and presented feedback regarding AMHSP funding and funding flows to Alberta Health and Invictus Analytics in May as part of AH’s review of AMHSP funding flows and alternative compensation rates. 
• Alberta Health was not receptive at that time, or as part of later discussions, to receiving commentary regarding AMHSP rates for clinical work; AMA will continue to raise this issue at the Provincial Strategy and Operations Committees.

Negotiate new compensation models including Alternative Relationship Plans and other alternate funding arrangements that support and align physician and system objectives. 

• AMA has implemented an ARP Working Group to advocate on behalf of members for improved ARP process and fairness.
• Representation, advocacy, and support for physicians considering or are currently in an alternative arrangement continues to be a key priority for the AMA. 
• AMA has contracted with an experienced ARP consultant to provide short-term, high-level support to members who are considering or implementing a clinical ARP or are transitioning from stipends to clinical ARP payment arrangement.

Negotiating on behalf of physicians paid through Alberta Health Services including:

• New policy and arrangements for overhead, on-call, stipends.
• Contracting of lab, DI, Cancer Care and other physician services. 
• Renewal of contractual arrangements or establishing amicable funding arrangements for AMA members paid by AHS.

• AMA has established a forum for meeting JTF appointees with AHS senior leadership to advocate for improvements to policy related to overhead, on-call and stipends.
• AMA has developed a test case for arbitration to check the jurisdictional application the Strategic Agreement.
• AMA continues to advocate for fair representation of physician groups that are associated with AHS payment arrangements. A consultant has been retained to assist with Laboratory Physicians contract negotiations.
• AHS has indicated that they have no mandate to continue stipend payments past December 31, 2021.
• AMA has proposed a partnership with AHS, towards ensuring continuance of essential medical services beyond December 31, 2021.
• The SAC is advocating at a provincial level and is keeping membership informed on progress through routine updates.

Activities

Year-end update

Support appropriate member billing practices including:

• Expand peer review activities including education and schedule modernization. 
• Support sections in schedule modernization/improvement efforts.
• Continue to develop tools like the fee navigator and billing training tools.

• AMA has established a Peer Review Committee and is seeking to further develop its educational component, including an anonymized communication mechanism with its membership.
• AMA is looking to modernize the fee schedule working closely with sections (e.g., new taxonomy and pricing strategy) and has appointed a representative to meet with AH to assist with this process.
• Schedule modernization work was put on hold by AH in June 2020 due to the COVID crisis and implementation of the Physician Funding Framework. AMA’s (formal) Peer Review process was put on hold in 2020 while awaiting a refreshed mandate, anonymized communication mechanism, as well as an Information Sharing Agreement with government (previous ISA was linked to the terminated AMA Agreement).
• Physician education regarding appropriate billing practices continues to be a focus and delivery will shift over the 2021/22 fiscal year to a combined synchronous/asynchronous approach within the new AMA learning environment.

Support members participating in or considering alternate compensation models including:

• Clinical alternate relationship plans.
• AMHSP arrangements.
• Private contracting models enabled through recent legislation.

• The AMA has hired a consultant to determine the optimal resourcing, structure and methods for providing AMA representation and support to physicians in all non-fee-for-service payment arrangements. This includes clinical ARPs, Academic Medicine and Health Services Program (AMHSP), AHS payment arrangements, new ARP models, and any new contract payment arrangements arising out of Bill 30. The consultant’s report was provided to the AMA on January 31, 2021. AMA has contracted with an ARP consultant to assist with negotiations related to stipends and clinical ARPs.

Activities

Year-end update

Formalize a regional financial services alliance with MD Financial

• The western Provincial and Territorial Medical Associations (DOBC, AMA, SMA, DM, YMA, NWTMA) have agreed on terms for a financial services alliance with MD Financial and Scotiabank. The alliance provides members with best-in-class investment, banking and insurance services. The parties are finalizing the support legal agreements and then each of the PTMAs will complete their respective approval processes.

Improve awareness and knowledge among members of the competitive advantages offered through the AMA group insurance plans.

• Awareness of AMA plans continues to grow with 64% of members carrying at least one ADIUM insurance product an increase of 206 members over the prior year.