'A good first step': Alberta ends daily physician billing limit, to repeal Bill 21 this fall

A physician's stethoscope is shown in this file photo.

The province rescinded the daily visit maximum that reduced physician compensation Monday, a move the health minister says will help increase Albertans' access to doctors.

At a joint press conference, Jason Copping and the president of the Alberta Medical Association announced the end of the daily cap policy. The move was part of the new agreement struck with physicians in September.

In 2020, then-health minister Tyler Shandro unilaterally ended the master agreement with Alberta physicians, which ultimately led to the AMA passing a non-confidence vote against him.

This fall, with around 45 per cent turnout of AMA membership, slightly more than 70 per cent voted in favour of the new agreement with the province.

Physician compensation is to increase by an average of four per cent for the next four years, including a one per cent lump sum "recognition payment" for work during the COVID-19 pandemic.

As part of the new deal, the province promised to repeal Bill 21 — legislation allowing it to end its contract with doctors without their say — in return for the AMA dropping its lawsuit seeking $255 million in damages and acknowledgements the Alberta government violated their charter rights.

Copping says the repeal bill is being drafted with the intention of being introduced in the legislature during this fall session.

"We're moving forward to implement the new agreement," he added. "Starting with ending the daily visit services cap policy and working to put rate increases in place."

When it was initially introduced in 2020, the daily visit cap was to lower healthcare delivery costs while supporting quality patient care and reducing physician burnout, the province claimed.

'THE ISSUES ARE FINANCIAL STABILITY'

Now, the health minister said he heard from doctors expressing concern over the cap, which would prevent them from seeing more than 50 patients or hosting evening clinics.

Under the new agreement, physicians are compensated 100 per cent for every visit, instead of receiving a discounted billing rate after exceeding the province's visit service maximum.

Removing that cap represents a "good first step forward" to repairing the relationship between Alberta doctors and specialists and the provincial government, said. Dr. Fredrykka Rinaldi, AMA president.

"The issues are financial stability," she explained. "Doctors have left the province, doctors have changed their practices to go into more niche practices like maybe OR assist, rather than trying to run an office that's financially unsustainable."

"(This way) physicians can look ahead and see over the next couple years that they can actually keep their business afloat," Rinaldi added. "We have to make it a positive, attractive environment."

Also part of the new agreement was a recognition that further innovations in compensation models were needed. Copping's latest mandate letter from the premier tasked him with "assessing alternative models of care and leveraging all health-care professionals."

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"That is one of the elements of the agreement I am personally very excited about," Copping said. "In my perspective, that's something I would like to drive faster, sooner to look at different methods and how we can use that to support family physicians."

Copping believes those compensation innovations will help retain doctors and attract others to the province.

Rinaldi said physicians and other specialist health-care professionals still have other outstanding issues they want addressed, including medical liability reimbursement that can range from $70,000 to $80,000 annually, continuing education costs and business support to rural practices.

"The important thing about this announcement was that we have to start somewhere," Rinaldi said.

"Let's start," she added, "with the simple and obvious that promotes physician trust in this government."

The Official Opposition said the province's pivot to ending the patient visit cap after implementing it two years ago shows that Albertans "can't trust the UCP with healthcare."

"If lifting this cap allows more Albertans to access a family doctor, then implementing it has denied Albertans access over the last two years in the midst of a global pandemic," said David Shepherd, NDP health critic.

"Instead of collaboration, the UCP attacked doctors and caused many to leave. Today, thanks to the UCP, hundreds of thousands of Albertans are without access to a family doctor."

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