Priority activity
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Update
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1. 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.
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- In January, the parties entered into interest-based negotiations as a way to move forward discussions for a provincial master agreement. Mr. Rick Wilson (a labour and management facilitator) was appointed by the parties to facilitate these discussions. Numerous joint meetings have been held in February, March, April, and dates are scheduled for May.
- A recent update on the discussions was included in the March 18, 2022, President’ Letter.
- Work on the lawsuit has continued through the months even without an agreement.
- On May 4-5, 2021, the questioning stage for the AMA lawsuit commenced with AMA interviewing the representative who was the lead negotiator for Government. On October 4, legal counsel for Government began its questioning sessions of AMA representatives. Questioning sessions were also held in December and will continue in the coming months with the AMA representatives.
- The next scheduled matter in the lawsuit is a case management meeting. Case management is a process by which the Court of Queen’s Bench appoints a judge to help ensure the lawsuit moves along in a timely manner and to settle disputes between the parties as they arise. Due to delays by the Court in appointing a case management judge and the appointed judge’s limited availability, May 26, 2022, was the soonest a substantive meeting could be set for.
- Following the case management meeting, the parties will resume the questioning process and continue to take the steps necessary to set the matter down for trial.
- The AMA board continues to receive regular updates relating to the lawsuit. Updates on the status of the claim are also provided to the membership through the Presidents’ Letters.
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2. Support members in local compensation discussions and through the provincial framework development including AHS-paid stipends, Physician on-call, contractual arrangements for Laboratory, DI and Cancer Care other physician AHS-contracted services.
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- The AMA has contracted several experienced ARP consultants to assist physicians with immediate clinical ARP exploration, development and implementation needs.
- Several physician groups have requested and received assistance with stipend discussions with AHS and/or cARP discussion with AH. As stipends have once again been extended, this area continues to be an area of greater focus and resource requirements for AMA Health Economic staff.
- On April 1, 2022, AMA-AH released a joint statement to halt any pending changes to physician compensation rates or programs until negotiations conclude. With respect to stipends, those with arrangements extended to March31, 2022 will now be extended to June 30, 2022, to facilitate talks.
- The AMA has also 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.
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3. Support members in local clinical ARP discussions and through provincial framework development considering contractual, sessional, or capitation-based ARPs.
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- Several physician groups have requested and received assistance with stipend discussions with AHS and/or cARP discussions with AH. As stipends have once again been extended, this area continues to be an area of greater focus and resource requirements for AMA Health Economics staff.
- A physician-led committee (AMA SAC) was also assembled to address, at a provincial level, the concerns expressed by various physician groups being impacted by changes in AHS stipend arrangements. Progress updates intended to keep membership informed have been developed and will continue as new information arises.
- On April 1, 2022, AMA-AH released a joint statement to halt any pending changes to physician compensation rates or programs until negotiations conclude. With respect to stipends, those with arrangements extended to March 31, 2022, will now be extended to June 30 to facilitate talks.
- AMA had some limited engagement in the Invictus ARP rate review project discussions with AH and Invictus, and is awaiting results from that review. AMA will continue to raise awareness on the complexities in physician payments and the current challenges.
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4. Support academic physicians in the negotiation of the Academic Health Services Plan and the supporting Individual Services Agreement.
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- The AMA’s AMHSP Council has focused on providing the academic medicine physician perspective and on illustrating the value of AMA engagement in representing this group to Alberta Health, the Faculties of Medicine and AHS. This has included a presentation of academic medicine physician results in the most recent AMA survey at a provincial table. The presentation included commentary regarding proposed policies in development.
- AMA continues to press for engagement in AMHSP policy work related to FTE, clinical compensation rates, included/excluded work and other areas impacting AMHSP compensation equity.
- 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.
- Two new members have been 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. A consultant has been engaged to refresh and update these interests (developed in 2020).
- A consultant has been engaged to support the AMA in provincial work to look at flexibility in payment models within AMHSPs; further information will be provided as those proceeds.
- Relationship-building with other stakeholder groups, including Faculties of Medicine and Faculty Associations continues to be a focus.
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5. Support members that are affected by Bill 30 and contracting out of physician services.
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- The AMA has recommended to government the following principles around third party contracting:
- All third-party arrangements must continue to support a strong and vibrant public health care system.
- Funding from the Physician Services Budget should flow to the physician who is then free to negotiate the local terms and conditions of a contract with the third party. Much like how this works with ARPs, the physician(s) could choose to assign their billings to the third party in exchange for administrative or other services negotiated between the parties.
- Physicians could use established payment mechanisms (i.e., FFS, ARPs) along with the established payment rates and workload measures. In addition, groups should have the ability to advance payment/workload models that currently do not exist (e.g., case rate).
- A contract with a group should not prevent or inhibit others from being able to practice in Alberta
- AMA representation of physician groups
- Laboratory physicians have requested support and formal representation though the AMA. A Laboratory Physician Representation Group (LPRG) was formed to represent the interests of laboratory physicians in all matters related to the reorganization of community laboratory services. The LPRG includes some physicians currently under contract to DynaLife and those who could potentially come under contract.
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