Essential Deliverables

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The essential deliverables for the coming year are discussed below. Spending in many of these areas has increased over current spending and that was achieved through efficiencies detailed earlier and by redeploying resources from other areas. A critical aspect to the plan is the flexibility of resources within each deliverable and across deliverables. We will respond where member needs arise as the year unfolds and resources will be shifted accordingly.

Essential Deliverables – high priority deliverables

Discussion

Plans for 2021

     

Enhance support and representation on compensation matters

With no AMA agreement in place discussions on physician compensation matters are going to take place in many venues and often in somewhat different ways. This includes existing models of payment through fee for service and alternate relationship plans (clinical and academic) but also whole new models that may come out of recent legislation. It is essential that the AMA support its members in achieving fair rates and terms of compensation in all settings.

  • A budget provision of $1.1 million has been included, which is roughly double current spending in this area.
  • The use of these funds will be based on the assessment of physicians needs and requirements and could be used to support physician leadership, consultant resources including legal and staff.
  • The additional resources will allow an enhanced commitment in all venues including cARP’s where we’re hearing an interest from government as well as members.
  • Representation funds will also be need in the AHS environment to address several issue including overhead, on-call, stipends and representation of individual physician groups in contract talks.
  • We’ll also be looking at the best organizational structure of the representation area to ensure best use of AMA resources available for these activities.
  • The resource provision included in the budget is based on an estimate developed by a senior staff working group; however, deployment will remain flexible so that we’re responding in the areas of greatest affect.

Member engagement & alignment

Members are the AMA; owners, leaders, workforce, etc. Given the changing relationship with government, the impact of COVID 19 and the rise of new technology, there are new ways to engage with members to get input and learn. A key requirement for this period of time, is that we develop and leverage our listening capabilities and be responsive to member needs. Alignment between member interests and the Association is what member engagement is all about.

  • During the pandemic we have engaged directly with thousands of members through webinars including physician wellness, business viability, ARP’s and virtual care codes to name a few. We are leveraging these learnings and make more resources available to expand this capability.
  • As we’re developing strategies to inform government and encourage a return to discussions on a new agreement, we needed structures that are close to membership and bring key stakeholders together. The Joint Task Force, which brings together, Primary and Specialty care leadership, EZMSAs and others, is a key vehicle for bring in input and coordinating activities across stakeholders.

Maintain advocacy activities including the current public campaign and our legal case

Our goal continues to be achieving a negotiated agreement with government but we need to be ready for the situation where activities at the negotiations table will not be adequate to bring that about. Resources have been included in the business plan for activities that inform the public and politicians in support of that goal.

  • An initial provision of $2.7 million has been included to support a range of advocacy activities including:
    • $670,000 over two years to fund the legal case.
    • $902,000 for the Joint Task Force, which is the structure established within the AMA, for getting information to and from members and encouraging actions and activities of stakeholder groups. The JTF includes Section and Zone leaders as well as other stakeholders. We’ve costed our highest level of activity over the past period and annualized it to ensure the Task Force can continue its critical work throughout the year.
    • $1.2 million for engaging with the public including an ongoing social media campaign, earned media and traditional paid media.
  • The balanced budget approach being taken ensures additional funding is available for greater levels of advocacy if needed.

Investment in government relations

While there was significant effort to form a strong and effective partnership with government, it has been challenged over the last while. Efforts here relate to both better understanding governments perspective and improving the relationship with them where possible.

  • Provisions are included for regular public surveys and lobbying support.
  • Staff resources aimed at improving relationships at the bureaucracy level.

Alliances with other key stakeholders

The AMA relies on relationships to satisfy the needs of members especially in these uncertain and challenging time. Understating the interests of other organizations and aligning activities with theirs will be important in the coming period.

  • CPSA – Especially in regard to HPA amendments or other issues related to self-regulation.
  • CMA – Support for Alberta physicians local and nationally.
  • Alberta Urban Municipalities Association and Rural Municipalities Association.
  • AHS
  • Other provider organization and associations

Maintenance of core capabilities

The goal is to achieve a negotiated agreement with government. Many of the essential deliverables above are aimed toward that in the best interest of physicians and the system. While we did look for efficiencies across the AMA operation, we also needed to identify what was important to maintain.

  • The activities identified under each of the Board’s long-term goals will continue but many will be resources at a lower level in order to achieve the essential deliverables over the next two years, including expertise in physician income and bus models, keeping an eye on legislation and advocating on informatics matters and physician health.
  • Physician supply - PRAC ID regulations are expected April 2021 and we will need to be ready and working with other parties in the context of a needs-based strategy.

A financial strategy that balanced the use of contingency funds with efficiency savings

The plan is built on a financial strategy that supports the achievement of the essential deliverables while maintaining a strong foundation and financial flexibility for moving forward.

  • Time horizon of 2 years at the end of which, board reserves will be fully funded and we will be moving to a balanced budget.
  • The plan includes significant real savings of roughly $3 million described elsewhere and the use of contingency funds. (Contingency funds are effectively AMA savings above the minimum board reserve requirements.)
  • A key aspect of the financial strategy is the ability to shift resources within each of the essential deliverables to meet the needs as they arise and the ability to shift resources across essential deliverables to those of greater value.
  • Balancing investment across activities to maximize marginal returns in each area (e.g. a small investment in one area may have a much greater impact than further investment in an area of great importance).

Physician Compensation (Including Income Equity)

The recent past has taught us that this government advances major policy initiatives with little discussion or engagement with the profession. We need to continue educating government and the public on the complexities of physician payment and be ready to respond as new policy comes forward from government.

  • Complete the Income Equity Initiative studies including the overhead, hours of work and market impact studies ($632,643).
  • To educate government and the public on the complexities of physician payments.
  • Advancing internal equity work as directed by the RF.
  • Physician Compensation Advisory Committee – Support AMA representatives at the committee to influence government on compensation matters.

The AMA advances patient-centered, quality care by advocating for and supporting physician leadership and wellness.