HQCA Evaluation: Crowfoot and Taber Clinics

December 11, 2019

Dear Members:

On December 9, the Health Quality Council of Alberta (HQCA) released its Final Report of the Crowfoot and Taber clinics case study evaluation.

The report concludes that strong team-based primary care results in better outcomes at a lower overall cost to the system. This finding is consistent with research in Alberta and other jurisdictions indicating the value of investing in the Patient’s Medical Home.

Investing in a well-supported Medical Home for all Albertans makes sense. As the AMA wrote to the Minister of Health in July:

“Evidence shows that Medical Home style primary care (continuous care and comprehensive service) dramatically reduces use of emergency and acute care services. … The Medical Home and Health Neighborhood integration should be the top priority for the health care system.”

AMA to Health Minister Tyler Shandro,
Opportunities for Government and AMA Collaboration, July 15, 2019

The HQCA report accredits much of the gains at Crowfoot and Taber to the alternative payment arrangements used by these clinics. Their payment models are supportive and aligned to their mission. The same terms should now be offered to other clinics without the undue administrative barriers that currently exist.

It is important to note that there are great Medical Homes operating today under fee-for-service payment arrangements in Alberta and in other provinces. We need to seek alignment of fee-for-service payments to the goals of the Medical Home.

If implemented, the Alberta Health consultation proposals would significantly reduce the payment support for comprehensive primary care and the Medical Home. They would also jeopardize care for patients with the greatest need for complex care management that is provided most effectively and safely in the community. Undoubtedly, this will increase costs in the acute care sector. Where is the logic in this?

Government’s proposals are penny-wise from a cost-cutter’s perspective, but pound-foolish from a system perspective. The Medical Home is an important example of cost efficiency combined with enhanced quality care. This is value.

Thank you to our colleagues, over a thousand now, who have provided feedback to us about the adverse impacts to quality care in Alberta that will occur if the Alberta Health and Alberta Health Services Insured Services Consultation proposals are unilaterally implemented.

Your comments are welcome in the following ways:

• Communicate with me privately and directly by email if you would like a reply: president@albertadoctors.org
• Comment publicly below on this President’s Letter.

In your service,

Christine P. Molnar, MD
President