The capitation clinical ARP (cARP) is a legacy funding model in Alberta that enables a team-based approach to primary care. The two legacy capitation cARPS are the Taber Clinic and the Crowfoot Village Family Practice.
Model Elements
Program Services
- Each program needs to define the basket of service that will be in-scope for the practice. For example, a practice may decide low risk maternity and delivery are out-of-scope.
- Program services include both direct and indirect patient care.
- Program services do not include physician on-call availability. Only the actual time physicians spend delivering program services while on call is funded.
- Program services include any out-of-province (medical reciprocal) patients.
Physician Benefit Programs
- ARP physicians are entitled to the same physician benefit programs as they would qualify for in FFS. For example, ARP physicians still receive Specialist On-Call Program payments if they qualify.
Locum Services
- Locum services are included in the FTEs hours for the program and are paid out of the clinical ARP funding. The actual amount required to attract locums for a weekend or evening may be higher than the AH funding generated by the locum hours worked. Therefore, the difference would be considered an overhead expense that needs to be paid by ARP physicians.
- Urban practices are required to engage private locums.
- The AMA’s Physician Locum Service supports rural practices in obtaining locum coverage.
Workload
- Physicians determine when and how program services will be delivered.
- The program must submit a proposed typical weekly clinic/shift work schedule as part of the application process.
Exclusions
- Clinical ARP funding only pays for medically insured services. Lecture-based teaching, practice management, travel, CME, and vacation are not funded.
Reporting Requirements
- As part of the application process, the program proposes approximately five key performance measures (e.g., service volumes, quality measures, physician-patient continuity, etc.).
| Type of Reporting | Frequency | By Whom |
| Service Event Reporting (Shadow Billing) | Daily/Weekly (on a regular basis) | All Participating Physicians |
| FTE Reports (annualized only) | Monthly | Authorized Representative |
| Performance Reporting | Quarterly | Authorized Representative |
| Performance Reporting | Annually | Authorized Representative |
Annualized Funding
Funding based solely on hours worked:
- The model was designed to fund physicians for full-time practices; part-time participation is allowed.
- Funding is based on number of physician full-time equivalents (FTEs) required to deliver services. The proposed FTE amount is determined through the application process, which includes data analysis and is subject to AH approval. The maximum funding is determined by multiplying the number of approved FTEs by the annual payment rate.
Annualized Payments
- Funding is transferred prospectively. The program receives their funding monthly in 12 equal installments, even if there are fluctuations in the monthly FTEs worked. The program can request a change in the monthly amount if there will be a sustained increase or decrease in FTEs worked, within the maximum annual approved funding limit. A reconciliation is done at the end of each fiscal year to ensure the funding paid equals the actual FTEs provided.
- Physicians are required to manage their work schedules and ensure that they provide the required number of program service hours during the fiscal year (April 1 to March 31).
- If a program provides more service hours than are funded, then they are not entitled to additional payments.