A promise made by MOU, a virtual care announcement
October 24, 2023
Dear Members,
Memorandum of Understanding
I have signed a Memorandum of Understanding with Minister of Health Adriana LaGrange that was referenced in last week’s release of the Modernizing Alberta’s Primary Health Care System (MAPS): Strategic Advisory Panel Final Report.
Government announced the MOU earlier today. I provided a quote, as you will see in the news release. Let me make a few additional comments.
The MAPS announcement raised questions of how decision-making will occur concerning primary care and family physician and rural generalist practices within the system. Minister LaGrange attended last night’s town hall in Red Deer and was asked about this point. She said: “We haven’t landed on anything yet … and we will build the model together.” I view this new MOU as a promise from the minister to the profession to work collaboratively toward solutions that will stabilize practices and allow them to thrive in the service of patients. The input of front-line physicians is essential to making any improvements in primary care.
The MOU commits the parties to work together regarding “design and implementation of a longitudinal family practice (LFP) physician compensation model that reflects family physicians’ and rural generalists’ extensive training, experience and leadership in primary health care.” This work will reflect the proposal we have submitted to government, developed with leaders in the Sections of Family Medicine and Rural Medicine. Members have not heard much about this proposal, and you will learn more, but some key elements would be recognized, for example:
- encounter type
- time-based payment (including direct care, indirect care, clinical administrative services)
- panel-based physician services payment (including complexity)
- team funding will be considered.
Under the MOU, we will also work on updating and improving existing funding models. The LFP will be one of a number of options available to quickly help family physicians transition to a more stable and robust funding model that incentivizes longitudinal comprehensive care.
At the Red Deer town hall last night, Minister LaGrange said she will work with AMA leadership on both long-term solutions and short-term stabilization, and this work will occur in the months before the provincial budget is tabled. She also acknowledged that the MAPS announcement, and specifically support in the form of $10,000 per physician, is insufficient to restore the health of community primary care clinics that have been steadily deteriorating over several years.
In town halls I have held so far, it’s clear that the AMA can do a better job engaging members. We will work with the Sections of Family Medicine and Rural Medicine, as well as primary care networks through the Physician Leads Executive, to be as transparent as we can with information about plans or decisions that affect you.
For all members who are not family physicians or rural generalists, thank you for your amazing support for primary care colleagues at this difficult time. This is not taken for granted. You will be hearing more from me on the crisis in acute care in the coming months. I am very aware that many facets of the system have been neglected and are facing serious challenges. Our team is working concurrently on advocacy efforts that will improve patient care on many fronts.
I will keep members informed on all these things.
Virtual care code changes going into effect
At the Fall Representative Forum, the minister made a commitment regarding amendments and enhancements to virtual care codes for mental health that the AMA had requested under the new agreement. Yesterday, Alberta Health released Bulletin 266 to implement these changes. The amendments enhance virtual mental health service capabilities for physicians, including parity with in-person services, a new fee code for psychiatric treatment of a complex patient and other changes requested by the AMA.
We appreciate that these changes have been put into effect. Work is continuing regarding good faith claims. I expect to announce very positive news on that front shortly as well. Watch for further information.
You can reach me anytime at president@albertadoctors.org. You can also comment on this letter on the AMA website.
Regards,
Paul Parks
President, Alberta Medical Association
2 comments
Commenting on this page is closed.
Trevor Day
6:46 PM on October 24, 2023
Hi Paul, thanks for the update and thank you for the ongoing advocacy.
To the comment - "She also acknowledged that the MAPS announcement, and specifically support in the form of $10,000 per physician, is insufficient to restore the health of community primary care clinics that have been steadily deteriorating over several years"
If the average Family Doctor bills 250,000 per year (AMA would have a better idea as to what this data would be) then $10,000 represents a 4% per annum increase in revenue. This is less than inflation.
This ~ $57 million investment sounds nice in a media headline, while also really not moving the needle to address the primary care crisis in our Province.
In a situation like this I would encourage the AMA to say "thank you, but no thank you" to the Minister, in order to get higher value propositions on the table. There's also a risk in tying up AMA resources to administer this benefit, which then cannot be allocated to other possible benefits of higher value.
Sincerely,
Trevor
Primary Care Physician, Edmonton.
Walter Mair
12:22 PM on October 27, 2023
For a practising physician with an office, 10,000 is woefully inadequate. After taxes, it works out to be around 6-7000 dollars per year, which is not enough to do much, especially run an office. BC's new rumuneration plan is quite attractive and some of the physicians there have increased their incomes substantially. Any new remuneration plan is going to have to pay the family docs a lot more, to encourage them to stay in Alberta. At the moment, I have retired from office practice and continue to practice geriatrics but am very glad not to have the responsibility of an office.
Regards
Walter Mair