Province, doctors reach tentative deal on new primary care model

Alberta’s $240-million Primary Care Network system is set for a major funding and governance overhaul in the months ahead under an important new deal aimed at providing patients more consistent and comprehensive health care outside the hospital.

The proposed agreement between the province and the Alberta Medical Association — still to be ratified by physicians — is also touted to make PCNs more accountable and efficient, while giving primary care greater prominence in the health system.

“This is a first step that gives Alberta’s health care the best possible chance to succeed,” Dr. Phillip van der Merwe, co-chair of the PCN physician leads executive, said Friday.

Alberta currently has 42 Primary Care Networks, which are collections of doctor’s offices in the same geographic area that work together to care for patients.

Under the current funding formula, the government provides $62 a year to a network for each patient in its catchment area — money primarily used to hire other health professionals, such as therapists, nutritionists, pharmacists and nurses, who are shared around the network.

The idea is that patients will receive better care if they have access to a team of health professionals.

However, reviews of PCNs in recent years found that some networks have not been making wise use of all the money they have received and have been too slow to provide comprehensive care.

Late last year, the province and the AMA finalized a pact to tackle issues related to quality of care and physician costs. Included was a pledge to jointly develop a new governance model and funding system that would allow PCNs to make needed improvements.

Van der Merwe said the governance model in place now has been ineffective because it requires all 42 PCNs to interact individually with the province like “islands of care.”

The proposed new system calls for PCNs to be organized into five different zones, all of which will be responsible for determining the overall health needs of their patient populations.

For example, a zone with a high incidence of chronic disease might need several nutritionists and pharmacists working in the PCNs, while another zone full of young families would require a different staffing mix.

As well, the new structure will provide an opportunity for PCNs to save money by consolidating services, such as payroll and data management at the zone level, he said.

Leaders from each zone will have a seat on a new provincial PCN committee, which will have representatives from Alberta Health Services and Alberta Health, and will be chaired by the deputy minister of health.

Van der Merwe said the new model gives primary care advocates better access to the health system’s top leaders, which is important for the province’s efforts to reduce patient traffic at hospitals and treat more people at home or in the community.

“This will open those doors, because finally there is this commitment that we are all part of the same landscape,” he said.

As for a new funding model, van der Merwe said details still have to be worked out. However, the plan is to halt the per-capita formula and instead provide funding based on population health needs. This means zones with higher needs might receive a boost in their grants, while others could receive less.

Van der Merwe said newly announced health transfers from the federal government earmarked specifically for mental health and home care could also be directed to PCNs, provided the new model is approved.

The ratification vote for PCN physicians will take place over the next month, ending on June 13.