After more than a year of planning and preparation, on March 24, the Government of Alberta announced that the Primary care physician compensation model (PCPCM) would go live on April 1. This new compensation option was developed jointly by AMA's primary care physician leaders and Alberta Health, and it is designed specifically for family physicians and rural generalists who deliver comprehensive, life-long patient care to a defined panel of patients.
Getting the model across the finish line was a momentous occasion for the PCPCM team, which includes physician leaders and AMA staff. “It required incredible dedication from everyone involved,” explains Dr. Sarah Bates, the President of the Section of Family Medicine and one of the physician leaders who helped develop the model. “There were many obstacles and delays along the way, but I believe the official launch signals government’s acknowledgement that family medicine should be a priority within our health care system.”
How it works
The PCPCM was created to recognize the extensive training, experience and leadership of primary care physicians. It is a hybrid between Alberta’s fee-for-service funding model, clinical ARPs and capitation that acknowledges essential work beyond direct patient care, supports physicians in addressing the unique needs of complex and vulnerable patients, and promotes patient attachment to physician practices.
Physicians were encouraged to review the elements and decide if the PCPCM fits their practice style. To help with that, the AMA created a financial calculator (login required) to provide a daily or weekly estimate based on an individual physician's practice characteristics. For physicians for whom the PCPCM is a fit, it is anticipated the model will result in an increase in annual income of approximately 25% for the average full-time family physician practicing longitudinal care.
“The PCPCM addresses some of the things physicians told us they needed in order to keep their practices viable and make it possible for them to continue providing the comprehensive, cradle-to-grave primary care that Albertans need and our health system relies on,” says Dr. Bates.
Helping physicians understand if the PCPCM is right for them
As soon as government announced in late 2024 that the model would move ahead, the PCPCM support team swung into action to ensure physicians had the information they needed to decide if the model was right for them. Over 20 web-based tools and resources were developed for physicians and clinic teams, including a detailed PCPCM operations manual, which includes more than 60 pages of guidance on eligibility, rules, rates and practice optimization. In addition, other tools such as a billing guide, a time away and locum guide and a practice agreement facilitation guide were created.
“We set out to develop tools that would help physicians make an informed choice,” says Dr. Bates. “Our goal was to answer as many questions as possible, as efficiently as possible, so physicians could decide if the PCPCM was right for them.”
As part of that process, several information sessions were held to support AMA members, clinic managers and practice teams. In total, almost 3,900 people attended these sessions. In addition, a PCPCM-specific newsletter offering information and updates was shared with interested members and more than 600 physician inquiries were fielded through the PCPCM inbox.
Enthusiastic interest from physicians
The PCPCM enrolment process involved members completing an expression of interest (EOI) form via the AMA member dashboard. Once the EOI was completed, members were sent the Alberta Health Primary Care Physician Compensation Model (PCPCM) Clinical Alternative Relationship Plan (ARP) Application form directly. To ensure there was enough interest in the model to proceed, government indicated they wanted to see 500 applications submitted to Alberta Health by March 14. As of March 24, the day of the government announcement, more than 1,000 expressions of interest had been received, and nearly 800 applications had been submitted, representing 39% of eligible physicians province-wide. Close to 20% of participating doctors are from rural municipalities, with a rough 50/50 split between male and female practitioners.
Physicians can enrol at any time – the March 24 Alberta Government Bulletin contains information on future deadlines – and are encouraged to reach out to [email protected]. The PCPCM Application Guide and troubleshooting resource may also be of help.
“Reaching this milestone was a significant achievement,” says Dr. Bates “We hope it will make a measurable difference in our ability to retain the family medicine specialists and rural generalists we already have and give other physicians a reason to choose Alberta. It’s definitely encouraging, but it’s only part of the story and we’re going to continue working to do whatever we can to strengthen and stabilize primary health care in Alberta.”
Positive feedback and still work to be done
SFM physician leaders have been hosting live and on-call chats with participating family doctors regarding the inner workings of the PCPCM. Here are examples of comments received from attendees at those sessions:
- "I seriously feel less stressed. Not overwhelmed with paperwork."
- "I feel like coming to work earlier."
- "I'm sleeping better."
- "I have a feeling of lightness and feeling valued."
But there is still work to be done. “The SFM will continue to advocate that the PCPCM become more inclusive and that the panel threshold for participation be lowered to allow comprehensive family physicians with smaller practices to participate,” said Dr. Bates in a recent communication to SFM members.